CPT 99213 · GEOGRAPHY
Reimbursement by state and locality.
Evaluation & management (CPT® descriptor withheld: AMA licence required). Every Medicare locality under CMS Medicare PFS · October 2026, priced with the official GPCI for that locality. Non-facility and facility amounts, non-QP conversion factor.
Highest
$120.13
CA · SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY)
Median
$96.71
across 109 localities
Lowest
$86.86
AR · ARKANSAS
Spread
38%
highest vs lowest
All 109 localities
National $95.19| Rank | State | Locality | Non-facility | Facility | vs national |
|---|---|---|---|---|---|
| 1 | CA | SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) | $120.13 | $65.70 | +26.2% |
| 2 | CA | SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) | $119.71 | $65.29 | +25.8% |
| 3 | AK | ALASKA* | $118.72 | $78.53 | +24.7% |
| 4 | CA | SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) | $117.69 | $64.47 | +23.6% |
| 5 | CA | SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) | $117.58 | $64.37 | +23.5% |
| 6 | CA | NAPA | $111.96 | $62.21 | +17.6% |
| 7 | CA | VALLEJO | $111.81 | $62.06 | +17.5% |
| 8 | NY | NYC SUBURBS/LONG ISLAND | $109.76 | $64.89 | +15.3% |
| 9 | NY | QUEENS | $108.18 | $63.56 | +13.6% |
| 10 | WA | SEATTLE (KING CNTY) | $107.88 | $61.57 | +13.3% |
| 11 | NY | MANHATTAN | $107.63 | $63.78 | +13.1% |
| 12 | DC | DC + MD/VA SUBURBS | $106.56 | $62.10 | +11.9% |
| 13 | CA | SANTA ROSA-PETALUMA | $106.22 | $59.87 | +11.6% |
| 14 | MA | METROPOLITAN BOSTON | $106.10 | $61.04 | +11.5% |
| 15 | NJ | NORTHERN NJ | $105.93 | $62.15 | +11.3% |
| 16 | CA | SANTA CRUZ-WATSONVILLE | $105.19 | $59.34 | +10.5% |
| 17 | CA | LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) | $104.89 | $60.24 | +10.2% |
| 18 | CA | SAN DIEGO-CHULA VISTA-CARLSBAD | $104.68 | $59.54 | +10% |
| 19 | CA | OXNARD-THOUSAND OAKS-VENTURA | $104.15 | $59.54 | +9.4% |
| 20 | CA | SACRAMENTO-ROSEVILLE-FOLSOM | $103.31 | $59.41 | +8.5% |
| 21 | CA | SANTA MARIA-SANTA BARBARA | $103.11 | $59.10 | +8.3% |
| 22 | CA | SALINAS | $102.90 | $59.15 | +8.1% |
| 23 | NY | POUGHKPSIE/N NYC SUBURBS | $102.41 | $61.08 | +7.6% |
| 24 | FL | MIAMI | $101.79 | $62.50 | +6.9% |
| 25 | NJ | REST OF NEW JERSEY | $101.71 | $60.49 | +6.8% |
| 26 | CA | SAN LUIS OBISPO-PASO ROBLES | $101.31 | $58.32 | +6.4% |
| 27 | HI | HAWAII, GUAM | $100.61 | $57.69 | +5.7% |
| 28 | OR | PORTLAND | $100.53 | $58.60 | +5.6% |
| 29 | CT | CONNECTICUT | $100.45 | $59.80 | +5.5% |
| 30 | CA | RIVERSIDE-SAN BERNARDINO-ONTARIO | $100.21 | $58.85 | +5.3% |
| 31 | MD | BALTIMORE/SURR. CNTYS | $100.16 | $59.66 | +5.2% |
| 32 | IL | CHICAGO | $99.63 | $61.70 | +4.7% |
| 33 | CA | BAKERSFIELD | $99.52 | $58.16 | +4.5% |
| 34 | CA | EL CENTRO | $99.23 | $57.87 | +4.2% |
| 35 | CA | CHICO | $99.22 | $57.85 | +4.2% |
| 36 | CA | FRESNO | $99.22 | $57.85 | +4.2% |
| 37 | CA | HANFORD-CORCORAN | $99.22 | $57.85 | +4.2% |
| 38 | CA | MADERA | $99.22 | $57.85 | +4.2% |
| 39 | CA | MERCED | $99.22 | $57.85 | +4.2% |
| 40 | CA | MODESTO | $99.22 | $57.85 | +4.2% |
| 41 | CA | REDDING | $99.22 | $57.85 | +4.2% |
| 42 | CA | STOCKTON | $99.22 | $57.85 | +4.2% |
| 43 | CA | VISALIA | $99.22 | $57.85 | +4.2% |
| 44 | CA | YUBA CITY | $99.22 | $57.85 | +4.2% |
| 45 | CA | REST OF CALIFORNIA | $99.22 | $57.85 | +4.2% |
| 46 | IL | SUBURBAN CHICAGO | $99.13 | $60.37 | +4.1% |
| 47 | PA | METROPOLITAN PHILADELPHIA | $98.55 | $59.26 | +3.5% |
| 48 | FL | FORT LAUDERDALE | $98.26 | $60.02 | +3.2% |
| 49 | CO | COLORADO | $98.18 | $58.02 | +3.1% |
| 50 | MA | REST OF MASSACHUSETTS | $97.86 | $58.12 | +2.8% |
| 51 | TX | AUSTIN | $97.77 | $57.83 | +2.7% |
| 52 | WA | REST OF WASHINGTON | $97.62 | $57.88 | +2.6% |
| 53 | RI | RHODE ISLAND | $97.30 | $58.31 | +2.2% |
| 54 | NH | NEW HAMPSHIRE | $96.82 | $57.53 | +1.7% |
| 55 | GA | ATLANTA | $96.71 | $58.36 | +1.6% |
| 56 | TX | HOUSTON | $96.33 | $58.85 | +1.2% |
| 57 | MD | REST OF MARYLAND | $95.97 | $57.77 | +0.8% |
| 58 | PR | PUERTO RICO | $95.68 | $57.53 | +0.5% |
| 59 | VI | VIRGIN ISLANDS | $95.68 | $57.53 | +0.5% |
| 60 | MI | DETROIT | $95.55 | $59.13 | +0.4% |
| 61 | MT | MONTANA** | $95.19 | $57.44 | 0% |
| 62 | TX | DALLAS | $94.96 | $57.37 | -0.2% |
| 63 | NV | NEVADA** | $94.74 | $56.96 | -0.5% |
| 64 | TX | GALVESTON | $94.68 | $57.20 | -0.5% |
| 65 | FL | REST OF FLORIDA | $94.56 | $58.48 | -0.7% |
| 66 | DE | DELAWARE | $94.52 | $57.23 | -0.7% |
| 67 | TX | FORT WORTH | $94.51 | $57.30 | -0.7% |
| 68 | MN | MINNESOTA | $94.49 | $55.65 | -0.7% |
| 69 | TX | BRAZORIA | $94.44 | $57.04 | -0.8% |
| 70 | WY | WYOMING** | $94.41 | $56.67 | -0.8% |
| 71 | IL | EAST ST. LOUIS | $94.34 | $59.62 | -0.9% |
| 72 | OR | REST OF OREGON | $94.10 | $56.51 | -1.1% |
| 73 | ME | SOUTHERN MAINE | $93.64 | $56.24 | -1.6% |
| 74 | VA | VIRGINIA | $93.48 | $56.38 | -1.8% |
| 75 | ND | NORTH DAKOTA** | $93.41 | $55.66 | -1.9% |
| 76 | AZ | ARIZONA | $93.25 | $56.67 | -2% |
| 77 | VT | VERMONT | $93.22 | $55.85 | -2.1% |
| 78 | SD | SOUTH DAKOTA** | $93.20 | $55.45 | -2.1% |
| 79 | MO | METROPOLITAN ST. LOUIS | $92.86 | $56.93 | -2.4% |
| 80 | LA | NEW ORLEANS | $92.72 | $57.21 | -2.6% |
| 81 | IL | REST OF ILLINOIS | $92.64 | $58.18 | -2.7% |
| 82 | TX | REST OF TEXAS | $92.41 | $56.60 | -2.9% |
| 83 | MO | METROPOLITAN KANSAS CITY | $92.15 | $56.71 | -3.2% |
| 84 | UT | UTAH | $91.96 | $56.48 | -3.4% |
| 85 | NY | REST OF NEW YORK | $91.86 | $56.01 | -3.5% |
| 86 | NM | NEW MEXICO | $91.75 | $57.14 | -3.6% |
| 87 | MI | REST OF MICHIGAN | $91.34 | $56.88 | -4% |
| 88 | WI | WISCONSIN | $91.06 | $54.91 | -4.3% |
| 89 | SC | SOUTH CAROLINA | $91.04 | $56.16 | -4.4% |
| 90 | PA | REST OF PENNSYLVANIA | $91.03 | $56.38 | -4.4% |
| 91 | OH | OHIO | $90.97 | $56.51 | -4.4% |
| 92 | NC | NORTH CAROLINA | $90.84 | $55.63 | -4.6% |
| 93 | TX | BEAUMONT | $90.59 | $56.24 | -4.8% |
| 94 | GA | REST OF GEORGIA | $90.50 | $56.84 | -4.9% |
| 95 | ME | REST OF MAINE | $90.16 | $55.43 | -5.3% |
| 96 | WV | WEST VIRGINIA | $90.10 | $57.30 | -5.3% |
| 97 | IN | INDIANA | $90.09 | $55.10 | -5.4% |
| 98 | ID | IDAHO | $89.71 | $54.98 | -5.8% |
| 99 | NE | NEBRASKA | $89.57 | $54.73 | -5.9% |
| 100 | KY | KENTUCKY | $89.52 | $55.97 | -6% |
| 101 | LA | REST OF LOUISIANA | $89.46 | $56.06 | -6% |
| 102 | TN | TENNESSEE | $89.36 | $55.05 | -6.1% |
| 103 | OK | OKLAHOMA | $89.30 | $55.60 | -6.2% |
| 104 | IA | IOWA | $89.23 | $54.70 | -6.3% |
| 105 | KS | KANSAS | $89.02 | $54.90 | -6.5% |
| 106 | MO | REST OF MISSOURI | $88.38 | $55.85 | -7.2% |
| 107 | AL | ALABAMA | $87.79 | $54.77 | -7.8% |
| 108 | MS | MISSISSIPPI | $87.63 | $55.13 | -7.9% |
| 109 | AR | ARKANSAS | $86.86 | $54.44 | -8.8% |
States with several localities (California, New York, Texas, Florida and others) show each one; check the locality you bill under rather than a state average. Amounts are before payer adjustments, sequestration and cost sharing.