CPT 99451

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CPT 99451 pays $35.40 in a non-facility setting and $30.06 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $33.14 in Arkansas to $47.02 in Alaska, a 42% spread.

National non-facility rate

$35.40

Office and other outpatient settings

Facility rate
$30.06

Hospital and ASC settings

Highest state
$47.02

Alaska

Lowest state
$33.14

Arkansas · 42% 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 $35.40
CPT 99451 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $35.40, national facility $30.06.
StateRate compared visuallyNon-facilityFacility
Alaska
$47.02$41.33
District of Columbia
$38.70$32.40
New York
$38.31$32.35
New Jersey
$38.05$32.03
California
$37.38$31.05
Washington
$37.24$31.15
Massachusetts
$37.09$31.08
Connecticut
$37.02$31.26
Florida
$37.02$31.66
Illinois
$36.66$31.49
Maryland
$36.28$30.71
Hawaii
$36.12$30.04
Rhode Island
$36.01$30.49
Colorado
$35.98$30.30
Oregon
$35.68$30.05
New Hampshire
$35.62$30.06
Pennsylvania
$35.52$30.28
Puerto Rico
$35.49$30.09
Virgin Islands
$35.49$30.09
Michigan
$35.45$30.44
Montana
$35.40$30.06
Georgia
$35.29$30.19
Texas
$35.25$29.99
Delaware
$35.23$29.95
Nevada
$35.14$29.79
Wyoming
$34.97$29.63
New Mexico
$34.88$29.98
Arizona
$34.84$29.67
West Virginia
$34.77$30.12
Virginia
$34.74$29.48
Utah
$34.61$29.59
Louisiana
$34.58$29.70
Minnesota
$34.53$29.03
Missouri
$34.53$29.62
Ohio
$34.52$29.64
Vermont
$34.48$29.19
North Dakota
$34.41$29.07
South Carolina
$34.37$29.43
Maine
$34.32$29.21
South Dakota
$34.30$28.95
Kentucky
$34.11$29.36
North Carolina
$34.11$29.12
Oklahoma
$33.92$29.15
Wisconsin
$33.81$28.69
Indiana
$33.79$28.84
Idaho
$33.70$28.78
Tennessee
$33.69$28.83
Kansas
$33.58$28.75
Nebraska
$33.57$28.64
Mississippi
$33.53$28.93
Iowa
$33.52$28.63
Alabama
$33.39$28.71
Arkansas
$33.14$28.54

Billed by 1 specialties

Commercial rates for 99451

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

See negotiated rates