Medical Procedure Costs in District of Columbia
District of Columbia Medicare physician rates are generally above the national average (+13.0%). One statewide locality — the ZIP tool still maps you onto that locality.
Look up any CPT in District of Columbia
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 District of Columbia averages are unweighted means of the state’s localities, not population-weighted.
How Medicare prices District of Columbia
The District of Columbia is unusual in the fee schedule: it forms its own high-cost locality that reaches beyond the city line to cover close-in Maryland and Virginia suburbs, including areas such as Montgomery and Prince George's counties and the Arlington and Alexandria side of the Potomac. Its geographic indices are among the highest in the country, reflecting the region's wages and office costs. As a result, DC-area Medicare-approved amounts run well above those in the rest of Maryland or Virginia, and the boundary of that locality can matter more than the state line. A patient in Bethesda is priced with Washington, not with Baltimore.
The Washington area is dense with hospitals, including multiple academic medical centers and large regional systems competing across the district and its suburbs. That density gives patients real choice within a short distance, which is rare in American health care. Federal employment also means an unusually well-insured population, so cash-pay and Medicare-rate comparisons are most useful for those outside employer coverage.
Enter a ZIP code to see how the DC locality applies to your address, whether you are in the District itself, Bethesda or Silver Spring on the Maryland side, or Arlington and Alexandria in Virginia.
Featured physician rates in District of Columbia
Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.
Other states
Medical costs in District of Columbia: questions
Across the 59 featured procedures on this page, District of Columbia sits above the national average by about 13%. Examples: incision & drainage of abscess $146, skin biopsy (tangential) $110, skin biopsy (punch) $139. Search any other CPT in the box above — those codes are in the tool, not as extra District of Columbia articles.
District of Columbia 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 District of Columbia’s locality when you enter a ZIP.