Medical Procedure Costs in Maine
Maine Medicare physician rates are generally below the national average (-4.1%). CMS uses 2 localities here, so a ZIP matters.
Look up any CPT in Maine
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 Maine averages are unweighted means of the state’s localities, not population-weighted.
How Medicare prices Maine
Maine is priced as a single statewide locality with indices close to, and in parts below, the national average, so Portland and the far northern county towns share one fee schedule. CMS has never needed to subdivide a state where even the largest metro is modest by national standards. The uniform pricing belies enormous differences in access between the populous southern coast and the vast interior. For Mainers, the published statewide rates are what Medicare approves everywhere from Kittery to Fort Kent.
Maine is among the most rural states in the country and has the oldest median age, a combination that concentrates specialty care in Portland and, to a lesser degree, Bangor and Lewiston. Residents of western and northern Maine can face hours of driving for procedures, and some in the far south use Boston hospitals for complex care. Consolidation has left a small number of systems covering most of the state.
Enter a ZIP code for your part of Maine, whether the Portland area, Lewiston-Auburn, Augusta, Bangor, the midcoast, or Aroostook County in the far north.
Maine payment localities (GPCI)
| Locality | Work | PE |
|---|---|---|
| southern maine | 1.000 | 0.991 |
| rest of maine | 1.000 | 0.920 |
GPCI of 1.000 equals the national average. Higher PE GPCI raises office-based procedures more than hospital physician lines.
Featured physician rates in Maine
Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.
Other states
Medical costs in Maine: questions
Across the 59 featured procedures on this page, Maine sits below the national average by about 4%. Examples: incision & drainage of abscess $123, skin biopsy (tangential) $92, skin biopsy (punch) $116. Search any other CPT in the box above — those codes are in the tool, not as extra Maine articles.
Maine has 2 payment localities. Practice-expense GPCI runs from 0.920 to 0.991 (1.000 is the national average). Enter a ZIP code for your part of Maine, whether the Portland area, Lewiston-Auburn, Augusta, Bangor, the midcoast, or Aroostook County in the far north.
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 Maine’s locality when you enter a ZIP.