Medical Procedure Costs in Idaho

Idaho Medicare physician rates are generally below the national average (-6.9%). One statewide locality — the ZIP tool still maps you onto that locality.

Look up any CPT in Idaho

Featured table below is 59 procedures. Search covers 7,500+ fee-schedule codes.

Try
vs national (featured set)
-6.9%
Medicare localities
1
PE GPCI 0.920
On this page
59
featured procedures · rest via search

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 Idaho averages are unweighted means of the state’s localities, not population-weighted.

How Medicare prices Idaho

All of Idaho shares a single payment locality, and its geographic indices are among the lowest in the West, so Medicare-approved amounts here undercut those in neighboring Washington and Oregon metro localities. Boise's rapid growth has not changed the statewide pricing structure; the fee schedule treats the Treasure Valley the same as the Panhandle or the eastern farm counties. For patients, that uniformity makes the statewide figures on this site a reliable guide anywhere in Idaho. Cross-border care is where pricing gets more interesting, since adjacent metro localities price higher.

Boise anchors the state's largest medical market, while the Panhandle looks to Spokane, Washington for much of its specialty care and eastern Idaho leans on Idaho Falls, Pocatello, and sometimes Salt Lake City. That means many Idahoans actually receive care priced under another state's locality. Rural and mountain communities face long drives for anything beyond primary care.

Check your ZIP code for local context across Idaho, from Boise and the Treasure Valley to Coeur d'Alene, Idaho Falls, Pocatello, Twin Falls, and the remote central mountains.

Featured physician rates in Idaho

ProcedureIdaho
Incision & Drainage of Abscess10060$120
Skin Biopsy (Tangential)11102$89
Skin Biopsy (Punch)11104$112
Destruction of Skin Lesion17000$62
Partial Mastectomy19301$570
Total Hip Replacement27130$1,060
Total Knee Replacement27447$1,058
Knee Arthroscopy29881$472
Upper Endoscopy (EGD)43235$299
Upper Endoscopy (EGD) With Biopsy43239$388
Colonoscopy (Diagnostic)45378$350
Colonoscopy With Biopsy45380$445
Colonoscopy With Polyp Removal45385$464
Laparoscopic Cholecystectomy47562$569
Laparoscopic Inguinal Hernia Repair49650$382
Laparoscopic Removal of Ovarian Cyst58661$537
Vaginal Delivery (Global)59400$1,979
Cesarean Delivery (Global)59510$2,191
Lumbar Discectomy63030$800
Cataract Surgery66984$437
MRI Brain Without Contrast70551$182
MRI Brain With Contrast70552$250
MRI Brain70553$295
Chest X-Ray71046$31
CT Chest Without Contrast71250$124
CT Chest With Contrast71260$155
MRI Cervical Spine72141$178
MRI Lumbar Spine72148$179
Shoulder X-Ray73030$33
MRI Shoulder73221$191
Knee X-Ray73560$32
MRI Knee73721$190
CT Abdomen & Pelvis Without Contrast74176$171
CT Abdomen & Pelvis With Contrast74177$279
Ultrasound Abdomen76700$106
Ultrasound Transvaginal76830$109
Ultrasound Pelvis76856$98
Diagnostic Mammogram77066$146
Screening Mammogram77067$117
Nuclear Stress Test78452$396
Psychiatric Evaluation90791$169
Psychiatric Evaluation With Medical Services90792$194
Psychotherapy (45 min)90834$111
Psychotherapy (60 min)90837$163
ECG/EKG93000$14
Echocardiogram93306$184
Stress Echocardiogram93350$173
Carotid Ultrasound93880$175
Laser Treatment for Skin96920$128
Physical Therapy (Therapeutic Exercise)97110$28
Physical Therapy (Manual Therapy)97140$27
PT Evaluation (Low Complexity)97161$94
PT Evaluation (Moderate Complexity)97162$94
Office Visit (New, Low)99203$110
Office Visit (New, Moderate-High)99204$167
Office Visit (New, High)99205$222
Office Visit (Established, Moderate)99213$90
Office Visit (Established, Moderate-High)99214$128
Office Visit (Established, High)99215$181

Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.

Medical costs in Idaho: questions

Across the 59 featured procedures on this page, Idaho sits below the national average by about 7%. Examples: incision & drainage of abscess $120, skin biopsy (tangential) $89, skin biopsy (punch) $112. Search any other CPT in the box above — those codes are in the tool, not as extra Idaho articles.

Idaho 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 Idaho’s locality when you enter a ZIP.

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.