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Medicare fee schedule lookup (CY2026)
What Medicare pays for a procedure code comes from the Physician Fee Schedule: each code carries work, practice expense and malpractice RVUs, and the payment is (RVUs adjusted by your locality's GPCIs) x the conversion factor - 33.4009 for CY2026. Pick a code to see its national rate, then choose your locality on the code's page to get the local rate. No code-by-locality pages: the rate is computed on the code page, where it belongs.
Common codes, national CY2026 rates
| Code | Short description | Non-facility | Facility |
|---|---|---|---|
99213 | Office o/p est low 20 min | $95.19 | $57.45 |
99214 | Office o/p est mod 30 min | $135.61 | $84.50 |
99203 | Office o/p new low 30 min | $117.57 | $71.48 |
99204 | Office o/p new mod 45 min | $177.36 | $116.90 |
93000 | Electrocardiogram complete | $15.36 | $15.36 |
97110 | Therapeutic exercises | $29.06 | $29.06 |
36415 | Coll venous bld venipuncture | $0.00 | $0.00 |
71046 | X-ray exam chest 2 views | $33.07 | $33.07 |
70553 | Mri brain stem w/o & w/dye | $316.97 | $316.97 |
43239 | Egd biopsy single/multiple | $418.85 | $123.58 |
Reading the numbers
- Non-facility is the rate in an office or clinic, where the practice bears the overhead; facility is lower because the hospital or ASC bills its own share separately.
- The rate shown is the Medicare allowed amount. After the annual deductible, Medicare pays 80% and the patient or a secondary payer owes 20%.
- Locality matters: the same code pays materially more in San Francisco than in rural Mississippi because each locality's GPCIs scale the three RVU parts separately. The selector on every code page does that math exactly as CMS does.
- Codes with no rate here are paid under other schedules (laboratory, DMEPOS, drugs are paid from ASP files) or are not payable - the code page says which.
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