On this page
CMS RVU26D · Effective 2026-10-01
99204 Medicare reimbursement rates in Illinois
Compare 99204 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 99204 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
$174.69–$188.76
4 of 4 localities have a supported rate.
Facility setting
$119.50–$128.00
4 of 4 localities have a supported rate.
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.
Where 99204 pays more and less in Illinois
4 payment localities
$174.69 to $188.76
Compare 99204 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
$188.76
Facility
$128.00
East St. Louis →
Office / nonfacility
$178.89
Facility
$123.27
Rest Of Illinois →
Office / nonfacility
$174.69
Facility
$119.50
Suburban Chicago →
Office / nonfacility
$186.38
Facility
$124.29
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
Primary care
Compare office and outpatient evaluation-and-management base rates.
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.