Medicare Fee Schedule New Jersey (2026): Rates by Locality
2026 Medicare physician fee schedule for New Jersey: 2 payment localities, where 99214 pays $144.77–$150.65 in the office. Any CPT code by city or ZIP.
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Rates by payment locality
| Payment locality | 99214 | 99213 | 97110 | 97530 |
|---|---|---|---|---|
| Northern New Jersey | $150.65Facility $91.37 | $105.93Facility $62.15 | $32.22Facility — | $39.23Facility — |
| Rest of New Jersey | $144.77Facility $88.97 | $101.71Facility $60.49 | $30.95Facility — | $37.53Facility — |
Examples are selected by 2024 national office/non-facility service volume among codes with supported current PFS rates. This is not a local or specialty utilization ranking. Amounts use the current release, not historical averages. See the utilization rankings
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Start with a service family. The service performed and the documentation decide the billing code.
- Office visits
- New-patient office visits
- Established-patient office visits
- Therapeutic exercise
- Therapeutic activities
- Manual therapy
- 99214Office visitEstablished patient, moderate complexity
- 99213Office visitEstablished patient, low complexity
- 97110Therapeutic exerciseOne-on-one, each 15 minutes
- 97530Therapeutic activitiesOne-on-one, each 15 minutes
- 36415VenipunctureRoutine venous sample
- 97112Neuromuscular reeducationBalance, coordination, proprioception, timed
- 99232Subsequent hospital visitModerate MDM or 35 minutes
- 97140Manual therapyOne or more regions, each 15 minutes
- 80053Metabolic panelFourteen blood chemistry tests
- 85025Complete CBCAutomated differential
- G2211Visit complexity add-onOngoing longitudinal patient relationship
- 99233Hospital follow-up visitSubsequent day, high complexity
- 17003Actinic keratosis destructionLesions 2-14, each additional
- 88305Tissue pathology examLevel IV specimen
- 80061Lipid panelCholesterol and triglycerides
- 93010ECG interpretationInterpretation and report only
- 99309Nursing facility visitSubsequent, moderate MDM or 30 minutes
- 83036A1c testLaboratory assay
- 84443TSH testThyroid-stimulating hormone
- 99215Office visitEstablished patient, high complexity
- 98941Chiropractic adjustmentSpinal, 3-4 regions
- 87798Infectious agent testAmplified probe, each organism
- 71045Chest X-raySingle view
- 99204Office visitNew patient, moderate complexity
- 99308Nursing facility visitSubsequent visit, low MDM
- G0439Annual wellness visitSubsequent visit
- 93000Electrocardiogram (ECG)Complete: tracing plus interpretation
- 99223Initial hospital visitHigh decision making or 75 minutes
- 92014Comprehensive eye examEstablished patient
- 99285ED visitHigh complexity decision making
- 99203New patient visitLow MDM or 30 minutes
- 95004Allergy skin prick testPercutaneous, immediate reaction, per test
- 66984Cataract surgeryStandard, without ECP or drainage device
- 92134Retinal OCTPosterior segment, retina
- 96372SC/IM injectionTherapeutic, prophylactic, or diagnostic
- 99490Chronic care managementClinical staff, first 20 minutes
- 90837Psychotherapy60 minutes, no E/M
- 93306Echocardiogram (TTE)Complete, with spectral and color Doppler
- 99212Office visitEstablished patient, straightforward
- 71046Chest X-rayTwo views
- 82306Vitamin D test25-hydroxy level
- 81001UrinalysisAutomated with microscopy
- 17000Premalignant lesion destructionFirst lesion
- 77067Screening mammogramBilateral, CAD included
- 99222Initial hospital visitModerate MDM or 55 minutes
- 95165Allergy extract preparationMultidose vials, per dose
- 77063Screening breast tomosynthesisBilateral screening add-on
- 99291Critical careInitial service, at least 30 minutes
- 81003UrinalysisAutomated, without microscopy
- 82570Urine creatinineUrine specimen
- 84439Free T4Unbound thyroxine
- G0283Electrical stimulationUnattended, other than wound care
- 99239Hospital discharge dayMore than 30 minutes
- 11721Nail debridementSix or more nails
- 80048Basic metabolic panelTotal calcium
- 97116Gait trainingEach 15 minutes, one-on-one
- 70450Head CTWithout contrast
- 20610Joint injectionMajor joint or bursa, no ultrasound
- 82607Vitamin B12Level assay
- 99284Emergency department visitModerate medical decision making
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- Northern New Jersey · NJ
- Rest of New Jersey · NJ
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Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
