Medical Procedure Costs in Delaware
Delaware Medicare physician rates are generally near the national average. One statewide locality — the ZIP tool still maps you onto that locality.
Look up any CPT in Delaware
Featured table below is 59 procedures. Search covers 7,500+ fee-schedule codes.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. These Delaware averages are unweighted means of the state’s localities, not population-weighted.
How Medicare prices Delaware
Delaware runs on a single statewide payment locality, one of the simplest setups in the fee schedule, with adjustment factors a notch above the national average given its Mid-Atlantic wage levels. From Wilmington down to the Sussex County beaches, the published Medicare rates are identical. The state's small size means locality boundaries would add little, and CMS has never subdivided it. What changes across the state is mostly provider availability rather than the approved amounts themselves.
Northern Delaware functions as part of the greater Philadelphia medical market, and Wilmington-area residents frequently use Philadelphia's academic centers for complex care. Downstate, Kent and Sussex counties rely on regional hospitals, and the fast-growing retiree population along the coast has stretched specialist capacity. Many beach-area patients travel north or into Maryland for procedures that require a subspecialist.
Run a ZIP lookup to see figures for Wilmington and New Castle County, Dover, or the Rehoboth and Lewes area in fast-growing Sussex County.
Featured physician rates in Delaware
Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.
Other states
Medical costs in Delaware: questions
Across the 59 featured procedures on this page, Delaware sits near the national average. Examples: incision & drainage of abscess $127, skin biopsy (tangential) $95, skin biopsy (punch) $120. Search any other CPT in the box above — those codes are in the tool, not as extra Delaware articles.
Delaware is one Medicare locality, so the physician fee schedule is statewide. Site of service (office vs hospital) and hospital facility fees still change what a patient is billed.
Medicare physician allowed amounts only — the professional fee after GPCI. They do not include hospital facility charges, anesthesia, or your plan’s contracted rate. Medicare patients typically owe 20% of the allowed amount after the Part B deductible, before Medigap.
Yes. The table is the featured set (59 procedures). The search box looks up 7,500+ payable codes from the 2026 fee schedule and applies Delaware’s locality when you enter a ZIP.