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CMS RVU26D · Effective 2026-10-01

99491 Medicare reimbursement rates

Compare 99491 physician payment amounts across CMS localities, including office and facility settings.

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

What does Medicare pay for 99491?

The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.

Office / nonfacility

$82.64–$115.23

109 of 109 localities have a supported rate.

Lowest: Arkansas

Highest: Alaska*

A spread of $32.59 per service.

Facility setting

$62.27–$89.97

109 of 109 localities have a supported rate.

Lowest: Arkansas

Highest: Alaska*

A spread of $27.70 per service.

These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.

Find 99491 in your payment locality →

Where 99491 pays more and less

109 payment localities

$82.64 to $115.23

$82.64$98.94$115.23
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

See how rates vary across the country

99491 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$82.64

$115.23

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$115.231
AL$83.371
AR$82.641
AZ$87.631
CA$92.10–$109.2429
CO$91.431
CT$93.591
DC$98.651
DE$88.691
FL$89.11–$95.263
GA$85.86–$90.512
GU$92.861
HI$92.861
IA$84.301
ID$84.711
IL$87.73–$93.604
IN$85.001
KS$84.231
KY$84.921
LA$84.91–$87.462
MA$91.28–$97.902
MD$89.87–$98.653
ME$85.16–$87.752
MI$86.43–$89.982
MN$88.111
MO$84.12–$87.453
MS$83.381
MT$89.171
NC$85.681
ND$87.391
NE$84.531
NH$90.281
NJ$94.79–$98.312
NM$86.791
NV$88.711
NY$86.48–$101.785
OH$86.071
OK$84.651
OR$88.14–$93.222
PA$86.06–$92.142
PR$89.531
RI$91.001
SC$85.991
SD$87.181
TN$84.511
TX$85.72–$91.038
UT$86.711
VA$87.68–$98.652
VI$89.531
VT$87.331
WA$91.03–$99.322
WI$85.591
WV$85.751
WY$88.401

Compare 99491 by payment locality

Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.

109 of 109 payment localities

99491 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama

Office

$83.37

Facility

$62.62
Alaska*

Office

$115.23

Facility

$89.97
Arizona

Office

$87.63

Facility

$64.65
Arkansas

Office

$82.64

Facility

$62.27
Atlanta

Office

$90.51

Facility

$66.42
Austin

Office

$91.03

Facility

$65.94
Bakersfield

Office

$92.42

Facility

$66.43
Baltimore/Surr. Cntys

Office

$93.33

Facility

$67.88
Beaumont

Office

$85.72

Facility

$64.14
Brazoria

Office

$88.60

Facility

$65.09
Chicago

Office

$93.60

Facility

$69.77
Chico

Office

$92.10

Facility

$66.11
Colorado

Office

$91.43

Facility

$66.20
Connecticut

Office

$93.59

Facility

$68.05
Dallas

Office

$89.06

Facility

$65.44
Dc + Md/Va Suburbs

Office

$98.65

Facility

$70.71
Delaware

Office

$88.69

Facility

$65.26
Detroit

Office

$89.98

Facility

$67.10
East St. Louis

Office

$89.34

Facility

$67.53
El Centro

Office

$92.12

Facility

$66.12
Fort Lauderdale

Office

$92.08

Facility

$68.06
Fort Worth

Office

$88.74

Facility

$65.36
Fresno

Office

$92.10

Facility

$66.11
Galveston

Office

$88.81

Facility

$65.26
Hanford-Corcoran

Office

$92.10

Facility

$66.11
Hawaii, Guam

Office

$92.86

Facility

$65.89
Houston

Office

$90.46

Facility

$66.91
Idaho

Office

$84.71

Facility

$62.89
Indiana

Office

$85.00

Facility

$63.02
Iowa

Office

$84.30

Facility

$62.60
Kansas

Office

$84.23

Facility

$62.79
Kentucky

Office

$84.92

Facility

$63.84
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

Office

$96.83

Facility

$68.77
Madera

Office

$92.10

Facility

$66.11
Manhattan

Office

$99.99

Facility

$72.44
Merced

Office

$92.10

Facility

$66.11
Metropolitan Boston

Office

$97.90

Facility

$69.59
Metropolitan Kansas City

Office

$86.91

Facility

$64.64
Metropolitan Philadelphia

Office

$92.14

Facility

$67.45
Metropolitan St. Louis

Office

$87.45

Facility

$64.88
Miami

Office

$95.26

Facility

$70.57
Minnesota

Office

$88.11

Facility

$63.71
Mississippi

Office

$83.38

Facility

$62.96
Modesto

Office

$92.10

Facility

$66.11
Montana**

Office

$89.17

Facility

$65.46
Napa

Office

$102.33

Facility

$71.07
Nebraska

Office

$84.53

Facility

$62.64
Nevada**

Office

$88.71

Facility

$64.98
New Hampshire

Office

$90.28

Facility

$65.60
New Mexico

Office

$86.79

Facility

$65.04
New Orleans

Office

$87.46

Facility

$65.15
North Carolina

Office

$85.68

Facility

$63.55
North Dakota**

Office

$87.39

Facility

$63.68
Northern Nj

Office

$98.31

Facility

$70.80
Nyc Suburbs/Long Island

Office

$101.78

Facility

$73.58
Ohio

Office

$86.07

Facility

$64.41
Oklahoma

Office

$84.65

Facility

$63.47
Oxnard-Thousand Oaks-Ventura

Office

$96.02

Facility

$67.98
Portland

Office

$93.22

Facility

$66.87
Poughkpsie/N Nyc Suburbs

Office

$95.49

Facility

$69.53
Puerto Rico

Office

$89.53

Facility

$65.56
Queens

Office

$100.28

Facility

$72.25
Redding

Office

$92.10

Facility

$66.11
Rest Of California

Office

$92.10

Facility

$66.11
Rest Of Florida

Office

$89.11

Facility

$66.43
Rest Of Georgia

Office

$85.86

Facility

$64.71
Rest Of Illinois

Office

$87.73

Facility

$66.08
Rest Of Louisiana

Office

$84.91

Facility

$63.92
Rest Of Maine

Office

$85.16

Facility

$63.34
Rest Of Maryland

Office

$89.87

Facility

$65.87
Rest Of Massachusetts

Office

$91.28

Facility

$66.31
Rest Of Michigan

Office

$86.43

Facility

$64.78
Rest Of Missouri

Office

$84.12

Facility

$63.68
Rest Of New Jersey

Office

$94.79

Facility

$68.90
Rest Of New York

Office

$86.48

Facility

$63.96
Rest Of Oregon

Office

$88.14

Facility

$64.52
Rest Of Pennsylvania

Office

$86.06

Facility

$64.29
Rest Of Texas

Office

$87.05

Facility

$64.54
Rest Of Washington

Office

$91.03

Facility

$66.05
Rhode Island

Office

$91.00

Facility

$66.50
Riverside-San Bernardino-Ontario

Office

$93.10

Facility

$67.11
Sacramento-Roseville-Folsom

Office

$95.47

Facility

$67.89
Salinas

Office

$95.07

Facility

$67.59
San Diego-Chula Vista-Carlsbad

Office

$96.38

Facility

$68.01
San Francisco-Oakland-Berkeley (Marin Cnty)

Office

$107.10

Facility

$73.67
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

Office

$107.00

Facility

$73.56
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

Office

$109.24

Facility

$75.04
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

Office

$108.82

Facility

$74.63
San Luis Obispo-Paso Robles

Office

$93.65

Facility

$66.64
Santa Cruz-Watsonville

Office

$96.59

Facility

$67.78
Santa Maria-Santa Barbara

Office

$95.18

Facility

$67.53
Santa Rosa-Petaluma

Office

$97.51

Facility

$68.39
Seattle (King Cnty)

Office

$99.32

Facility

$70.23
South Carolina

Office

$85.99

Facility

$64.08
South Dakota**

Office

$87.18

Facility

$63.47
Southern Maine

Office

$87.75

Facility

$64.25
Stockton

Office

$92.10

Facility

$66.11
Suburban Chicago

Office

$92.83

Facility

$68.47
Tennessee

Office

$84.51

Facility

$62.95
Utah

Office

$86.71

Facility

$64.42
Vallejo

Office

$102.18

Facility

$70.93
Vermont

Office

$87.33

Facility

$63.86
Virgin Islands

Office

$89.53

Facility

$65.56
Virginia

Office

$87.68

Facility

$64.37
Visalia

Office

$92.10

Facility

$66.11
West Virginia

Office

$85.75

Facility

$65.14
Wisconsin

Office

$85.59

Facility

$62.87
Wyoming**

Office

$88.40

Facility

$64.68
Yuba City

Office

$92.10

Facility

$66.11

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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 99491PPRRVU2026_Oct_nonQPP.csv, line 13,155 (RVU26D)