2026 Medicare rates, by CPT code and ZIP
Look up what any procedure costs, by CPT code.
Search by CPT code or by name, add a ZIP for your local rate, and see the full hospital total, not just the doctor's fee.
7,500+ priced codes · 43,000 ZIP codes · 66 featured procedures in every state
How much does a medical procedure cost?
It depends on the procedure, where it is done and where you live. Here is what Medicare pays in 2026 for some of the most searched ones, nationally. Private insurance usually pays more, and your own share depends on your deductible and coinsurance.
- Office Visit (Established, Moderate) in a doctor's office$95
- MRI Lumbar Spine at an imaging center$192
- Colonoscopy (Diagnostic) at a hospital outpatient department, all in$1,115
- Cataract Surgery at a surgery center, all in$1,718
- Total Knee Replacement at a hospital outpatient department, all in$14,276
Look up procedure cost by CPT code
The same formula CMS uses to pay physicians, applied to your ZIP.
01
Enter a ZIP, or skip it
A ZIP maps to one of 112 Medicare pricing localities. Skip it to see the national unadjusted rate; add it to apply GPCI geographic adjustments.
02
Search a name or CPT
Type echocardiogram, 93306, or knee replacement. Featured pages below are a curated subset, not the whole schedule.
03
Read the full cost
You get the Medicare allowed amount for the physician, office vs hospital, and for common procedures the full hospital or surgery center total. Anesthesia is billed separately.
Featured categories
Jump to the curated list, or search above for any other CPT.
Featured procedure pages
The procedures people look up most, with 2026 national Medicare totals. Open a page and enter a ZIP for the local rate.
Cataract Surgery
66984$2,820
MRI Lumbar Spine
72148$312
MRI Brain Without Contrast
70551$312
Colonoscopy (Diagnostic)
45378$1,115
Total Knee Replacement
27447$14,276
Total Hip Replacement
27130$14,279
Screening Mammogram
77067$126
CT Head Without Contrast
70450$146
Nuclear Stress Test
78452$1,397
Exercise Stress Test
93015$73
Office Visit (Established, Moderate)
99213$95
Physical Therapy (Therapeutic Exercise)
97110$29
Billing guides
How US medical bills actually work, written to explain the numbers.
How Medical Billing Actually Works
A plain-English walkthrough of CPT codes, charges vs. allowed amounts, how a claim moves through the system, and why your first bill is often wrong.
6 min readHow to Negotiate a Medical Bill
Step-by-step tactics for lowering a medical bill: itemized bill audits, common errors, cash discounts, charity care, payment plans, and appeals.
7 min readFacility Fees: Why the Same Procedure Costs More at a Hospital
Why identical care can cost far more in a hospital outpatient department: provider-based billing, facility fees, and how to ask where you will be treated.
6 min readThe No Surprises Act: What It Protects You From (and What It Does Not)
How the No Surprises Act blocks balance billing for emergency and out-of-network care, what good faith estimates cover, and the gaps that remain.
7 min readPaying for Care Without Insurance
Practical options for uninsured patients: cash prices, community health centers, hospital financial assistance, marketplace subsidies, and drug discounts.
7 min readHow to Read an EOB (Explanation of Benefits)
What every field on an explanation of benefits means, how EOBs differ from bills, and how to match the two documents to catch costly errors.
6 min readBefore you search
The 2026 Medicare Physician Fee Schedule published by CMS, plus the CMS hospital outpatient (OPPS) and ambulatory surgery center addenda for facility fees. We do not invent or crowdsource prices.
Yes, in the search box, by code or by name. About 19,000 CPT and HCPCS codes are searchable, and roughly 7,500 physician codes carry full ZIP-level pricing. Dedicated pages exist for 66 commonly searched procedures, plus a page for each of those procedures in every state.
No. These are Medicare allowed amounts. Private plans often allow more, hospitals add facility fees, and your deductible and coinsurance still apply. Use the number as a public benchmark, then confirm with the provider and insurer.
Medicare pays a different practice-expense RVU when the service is in a facility. The hospital then bills its own facility fee on a separate claim. The physician line is often lower in a hospital while the total bill is higher, which is why every procedure page also shows the full episode cost.
Independent cost tool. CMS data.
Not a hospital, insurer, or medical practice. Corrections: contact@medcostcheck.com
How the numbers are calculated