Medical Procedure Costs in Maryland
Maryland Medicare physician rates are generally above the national average (+3.3%). CMS uses 2 localities here, so a ZIP matters.
Look up any CPT in Maryland
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 Maryland averages are unweighted means of the state’s localities, not population-weighted.
How Medicare prices Maryland
Maryland's Medicare physician pricing is split geographically: Baltimore and its surrounding counties form one locality, the rest of the state another, and, unusually, the Washington suburbs including Montgomery and Prince George's counties are priced inside the District of Columbia's high-cost locality rather than either Maryland one. That three-way carve means a Rockville procedure is approved at DC-area rates while an identical one in Frederick or Salisbury is not. Baltimore-area adjustments sit above rest-of-state levels but below the DC locality. Few states have their pricing shaped this much by a neighboring jurisdiction.
Maryland is also the only state with an all-payer rate-setting system for hospital services, so hospital-side billing works differently here than anywhere else in the country, though physician fees still follow the standard Medicare schedule. Baltimore's academic medical centers rank among the most prominent in the world and draw patients globally. The Eastern Shore and western Maryland are far more rural, with patients often traveling to Baltimore, Annapolis, or across state lines.
A ZIP lookup matters in Maryland because three different locality treatments are in play: check whether you fall in the Baltimore area, the DC suburbs like Bethesda and Silver Spring, or rest-of-state regions like Frederick, Hagerstown, and the Eastern Shore.
Maryland payment localities (GPCI)
| Locality | Work | PE |
|---|---|---|
| baltimore/surr. cntys | 1.016 | 1.073 |
| rest of maryland | 1.010 | 1.012 |
GPCI of 1.000 equals the national average. Higher PE GPCI raises office-based procedures more than hospital physician lines.
Featured physician rates in Maryland
Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.
Other states
Medical costs in Maryland: questions
Across the 59 featured procedures on this page, Maryland sits above the national average by about 3%. Examples: incision & drainage of abscess $133, skin biopsy (tangential) $99, skin biopsy (punch) $126. Search any other CPT in the box above — those codes are in the tool, not as extra Maryland articles.
Maryland has 2 payment localities. Practice-expense GPCI runs from 1.012 to 1.073 (1.000 is the national average). A ZIP lookup matters in Maryland because three different locality treatments are in play: check whether you fall in the Baltimore area, the DC suburbs like Bethesda and Silver Spring, or rest-of-state regions like Frederick, Hagerstown, and the Eastern Shore.
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 Maryland’s locality when you enter a ZIP.