CPT 99497 pays $86.84 in a non-facility setting and $65.80 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $80.63 in Arkansas to $112.74 in Alaska, a 40% spread.
National non-facility rate
$86.84
Office and other outpatient settings
Hospital and ASC settings
Alaska
Arkansas · 40% spread
53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.
| State | Rate compared visually | Non-facility | Facility |
|---|---|---|---|
| Alaska | $112.74 | $90.33 | |
| District of Columbia | $95.89 | $71.10 | |
| New York | $94.20 | $70.72 | |
| New Jersey | $93.92 | $70.23 | |
| California | $93.44 | $68.55 | |
| Washington | $92.51 | $68.52 | |
| Massachusetts | $91.97 | $68.32 | |
| Connecticut | $91.07 | $68.41 | |
| Hawaii | $90.20 | $66.27 | |
| Florida | $89.80 | $68.69 | |
| Maryland | $89.16 | $67.22 | |
| Colorado | $88.94 | $66.55 | |
| Illinois | $88.62 | $68.29 | |
| Rhode Island | $88.58 | $66.85 | |
| Oregon | $88.22 | $66.05 | |
| New Hampshire | $87.85 | $65.94 | |
| Puerto Rico | $87.17 | $65.89 | |
| Virgin Islands | $87.17 | $65.89 | |
| Montana | $86.84 | $65.79 | |
| Pennsylvania | $86.81 | $66.20 | |
| Delaware | $86.38 | $65.59 | |
| Texas | $86.38 | $65.66 | |
| Nevada | $86.37 | $65.31 | |
| Wyoming | $86.06 | $65.02 | |
| Michigan | $86.01 | $66.25 | |
| Georgia | $85.96 | $65.88 | |
| Minnesota | $85.70 | $64.05 | |
| Virginia | $85.39 | $64.70 | |
| Arizona | $85.36 | $64.97 | |
| North Dakota | $85.06 | $64.01 | |
| Vermont | $85.02 | $64.19 | |
| South Dakota | $84.85 | $63.80 | |
| New Mexico | $84.65 | $65.35 | |
| Utah | $84.51 | $64.73 | |
| Maine | $84.22 | $64.11 | |
| Louisiana | $84.05 | $64.84 | |
| Missouri | $84.02 | $64.71 | |
| Ohio | $83.93 | $64.72 | |
| South Carolina | $83.83 | $64.38 | |
| West Virginia | $83.72 | $65.43 | |
| North Carolina | $83.50 | $63.86 | |
| Wisconsin | $83.35 | $63.19 | |
| Kentucky | $82.84 | $64.14 | |
| Indiana | $82.83 | $63.33 | |
| Idaho | $82.56 | $63.20 | |
| Oklahoma | $82.56 | $63.77 | |
| Tennessee | $82.38 | $63.25 | |
| Nebraska | $82.37 | $62.95 | |
| Iowa | $82.16 | $62.91 | |
| Kansas | $82.11 | $63.09 | |
| Mississippi | $81.37 | $63.25 | |
| Alabama | $81.32 | $62.91 | |
| Arkansas | $80.63 | $62.55 |
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.
See negotiated rates