CPT 99427

Principal Care Mgmt Svc Ea Addl 30 Staff Cal Mo

CPT 99427 pays $54.11 in a non-facility setting and $31.40 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $49.25 in Arkansas to $67.08 in Alaska, a 36% spread.

National non-facility rate

$54.11

Office and other outpatient settings

Facility rate
$31.40

Hospital and ASC settings

Highest state
$67.08

Alaska

Lowest state
$49.25

Arkansas · 36% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $54.11
CPT 99427 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $54.11, national facility $31.40.
StateRate compared visuallyNon-facilityFacility
Alaska
$67.08$42.90
District of Columbia
$60.69$33.94
California
$59.46$32.58
New York
$59.15$33.82
New Jersey
$59.09$33.51
Washington
$58.53$32.63
Massachusetts
$58.07$32.55
Hawaii
$57.34$31.52
Connecticut
$57.15$32.68
Colorado
$55.87$31.70
Florida
$55.79$33.00
Maryland
$55.77$32.09
Oregon
$55.37$31.45
Rhode Island
$55.33$31.87
New Hampshire
$55.08$31.43
Illinois
$54.74$32.80
Puerto Rico
$54.40$31.44
Virgin Islands
$54.40$31.44
Montana
$54.11$31.39
Nevada
$53.86$31.12
Pennsylvania
$53.85$31.60
Minnesota
$53.77$30.40
Delaware
$53.71$31.27
Texas
$53.68$31.32
Wyoming
$53.68$30.96
Georgia
$53.15$31.48
Virginia
$53.13$30.80
North Dakota
$53.12$30.40
Michigan
$53.04$31.71
South Dakota
$53.00$30.29
Vermont
$53.00$30.51
Arizona
$52.98$30.97
Utah
$52.22$30.87
Maine
$52.21$30.51
New Mexico
$52.06$31.23
Wisconsin
$51.75$29.99
Missouri
$51.72$30.88
Louisiana
$51.69$30.95
South Carolina
$51.68$30.69
Ohio
$51.62$30.89
North Carolina
$51.58$30.39
Indiana
$51.15$30.10
West Virginia
$51.07$31.33
Idaho
$50.93$30.04
Nebraska
$50.86$29.90
Kentucky
$50.78$30.59
Tennessee
$50.72$30.08
Iowa
$50.66$29.88
Oklahoma
$50.66$30.38
Kansas
$50.52$29.99
Alabama
$49.79$29.92
Mississippi
$49.68$30.13
Arkansas
$49.25$29.74

Billed by 1 specialties

Commercial rates for 99427

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates