Medical Procedure Cost Guide

Medicare benchmark rates for 80+ common procedures. Use these as a reference to understand what providers are typically paid — and whether your bill is fair.

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Office VisitEmergency RoomPreventive CareHospital CareCritical CareLabImagingCardiologyMental HealthPhysical TherapyMinor ProcedureProcedureSurgeryVaccine

Office Visit

Office Visit - New Patient, StraightforwardCPT 99202$92.45Medicare rateOffice Visit - New Patient, Low ComplexityCPT 99203$133.86Medicare rateOffice Visit - New Patient, Moderate ComplexityCPT 99204$204.16Medicare rateOffice Visit - New Patient, High ComplexityCPT 99205$261.88Medicare rateOffice Visit - Established Patient, MinimalCPT 99211$24.22Medicare rateOffice Visit - Established Patient, StraightforwardCPT 99212$57.52Medicare rateOffice Visit - Established Patient, Low ComplexityCPT 99213$96.93Medicare rateOffice Visit - Established Patient, Moderate ComplexityCPT 99214$147.27Medicare rateOffice Visit - Established Patient, High ComplexityCPT 99215$207.57Medicare rate

Emergency Room

Emergency Room Visit, MinorCPT 99281$22.09Medicare rateEmergency Room Visit, Low ComplexityCPT 99282$58.91Medicare rateEmergency Room Visit, Moderate ComplexityCPT 99283$124.75Medicare rateEmergency Room Visit, Moderately High ComplexityCPT 99284$221.48Medicare rateEmergency Room Visit, High ComplexityCPT 99285$348.14Medicare rate

Preventive Care

Annual Physical - New Patient, Age 18-39CPT 99385$175.97Medicare rateAnnual Physical - New Patient, Age 40-64CPT 99386$207.57Medicare rateAnnual Physical - Established Patient, Age 18-39CPT 99395$172.19Medicare rateAnnual Physical - Established Patient, Age 40-64CPT 99396$192.10Medicare rate

Hospital Care

Initial Hospital Care, Low ComplexityCPT 99221$130.03Medicare rateInitial Hospital Care, Moderate ComplexityCPT 99222$186.88Medicare rateInitial Hospital Care, High ComplexityCPT 99223$254.43Medicare rateSubsequent Hospital Care, Moderate ComplexityCPT 99232$80.18Medicare rateSubsequent Hospital Care, High ComplexityCPT 99233$116.43Medicare rateHospital Discharge, 30 Minutes or LessCPT 99238$83.95Medicare rateHospital Discharge, More Than 30 MinutesCPT 99239$124.75Medicare rate

Critical Care

Critical Care, First 30-74 MinutesCPT 99291$243.73Medicare rate

Lab

Complete Blood Count (CBC) with DifferentialCPT 85025$10.71Medicare rateComplete Blood Count (CBC) without DifferentialCPT 85027$9.72Medicare rateComprehensive Metabolic Panel (CMP)CPT 80053$14.22Medicare rateBasic Metabolic Panel (BMP)CPT 80048$11.86Medicare rateLipid Panel (Cholesterol)CPT 80061$19.89Medicare rateHemoglobin A1c (HbA1c)CPT 83036$12.26Medicare rateThyroid Stimulating Hormone (TSH)CPT 84443$18.74Medicare rateProstate Specific Antigen (PSA)CPT 84153$24.31Medicare rateBlood Glucose TestCPT 82947$6.27Medicare rateCreatinine Blood TestCPT 82565$7.95Medicare rateALT Liver Enzyme TestCPT 84460$7.95Medicare rateAST Liver Enzyme TestCPT 84450$7.95Medicare rateRoutine Blood Draw (Venipuncture)CPT 36415$3.83Medicare rate

Imaging

Chest X-Ray, 2 ViewsCPT 71046$41.53Medicare rateShoulder X-Ray, Minimum 2 ViewsCPT 73030$44.55Medicare rateKnee X-Ray, 3 ViewsCPT 73562$45.78Medicare rateWrist X-Ray, 2 ViewsCPT 73100$37.76Medicare rateFoot X-Ray, AP and LateralCPT 73630$39.24Medicare rateCT Scan - Head/Brain without ContrastCPT 70450$167.27Medicare rateMRI Brain with and without ContrastCPT 70553$369.85Medicare rateCT Scan - Chest without ContrastCPT 71250$219.47Medicare rateCT Scan - Abdomen with ContrastCPT 74177$238.65Medicare rateCT Scan - Abdomen and Pelvis with ContrastCPT 74178$287.43Medicare rateMRI Cervical Spine without ContrastCPT 72141$308.74Medicare rateMRI Lumbar Spine without ContrastCPT 72148$310.45Medicare rateMRI Shoulder/Upper Extremity Joint without ContrastCPT 73221$295.32Medicare rateMRI Knee/Lower Extremity Joint without ContrastCPT 73721$295.32Medicare rateUltrasound Abdomen CompleteCPT 76700$89.43Medicare rate

Cardiology

Echocardiogram with Doppler (Complete)CPT 93306$309.87Medicare rateElectrocardiogram (EKG/ECG), RoutineCPT 93000$18.74Medicare rateCardiovascular Stress TestCPT 93016$24.22Medicare rateCardiac CatheterizationCPT 93458$799.85Medicare rate

Mental Health

Psychiatric Diagnostic EvaluationCPT 90791$161.75Medicare ratePsychotherapy, 30 MinutesCPT 90832$59.25Medicare ratePsychotherapy, 45 MinutesCPT 90834$82.11Medicare ratePsychotherapy, 60 MinutesCPT 90837$109.47Medicare rateGroup PsychotherapyCPT 90853$25.20Medicare rate

Physical Therapy

Physical Therapy - Therapeutic ExerciseCPT 97110$32.81Medicare ratePhysical Therapy - Manual TherapyCPT 97140$33.22Medicare ratePhysical Therapy - Therapeutic ActivitiesCPT 97530$33.22Medicare ratePhysical Therapy - Hot/Cold PacksCPT 97010$6.98Medicare rate

Minor Procedure

Incision and Drainage of AbscessCPT 10060$77.45Medicare rateSimple Laceration Repair, 2.5 cm or LessCPT 12001$94.22Medicare rateSimple Laceration Repair, 2.6-7.5 cmCPT 12002$101.56Medicare rate

Procedure

Upper GI Endoscopy with BiopsyCPT 43239$264.87Medicare rateDiagnostic ColonoscopyCPT 45378$228.45Medicare rateColonoscopy with BiopsyCPT 45380$287.43Medicare rateColonoscopy with PolypectomyCPT 45385$354.25Medicare rate

Surgery

Laparoscopic Cholecystectomy (Gallbladder Removal)CPT 47562$649.87Medicare rateTotal Knee Replacement (Arthroplasty)CPT 27447$1,318.45Medicare rateTotal Hip Replacement (Arthroplasty)CPT 27130$1,443.22Medicare rateKnee Arthroscopy with MeniscectomyCPT 29881$564.32Medicare rate

Vaccine

Immunization Administration, First InjectionCPT 90471$29.44Medicare rate

Rates shown are 2024 CMS Medicare national average payment rates and are provided for informational purposes only. Actual payments vary by geographic area, facility type, and payer contract. Commercial insurers typically pay 1.2–2× Medicare.