Medical Procedure Costs in New Jersey
New Jersey Medicare physician rates are generally above the national average (+9.7%). CMS uses 2 localities here, so a ZIP matters.
Look up any CPT in New Jersey
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 New Jersey averages are unweighted means of the state’s localities, not population-weighted.
How Medicare prices New Jersey
New Jersey is split into two payment localities: northern New Jersey, which carries higher adjustments befitting its position in the New York metropolitan orbit, and the rest of the state to the south. Both localities price above the national average, but the northern one ranks among the more expensive in the country. The dividing line means a procedure in Bergen County is approved at a higher amount than the same one in Cherry Hill or along the shore. South Jersey's pricing gravity pulls toward Philadelphia even though its locality is its own.
New Jersey may be the ultimate cross-border care state: North Jersey residents flow into Manhattan hospitals, South Jersey residents into Philadelphia's academic centers, and the state's own large systems compete hard in between. Dense population means most residents have multiple hospitals within a short drive, which is real negotiating leverage for a cash-pay patient. The shore counties see seasonal population surges that strain capacity each summer.
Look up your ZIP code to see whether northern or rest-of-state New Jersey pricing applies, from Newark, Jersey City, and Bergen County down to Trenton, Cherry Hill, and the Jersey Shore.
New Jersey payment localities (GPCI)
| Locality | Work | PE |
|---|---|---|
| northern nj | 1.063 | 1.160 |
| rest of new jersey | 1.040 | 1.092 |
GPCI of 1.000 equals the national average. Higher PE GPCI raises office-based procedures more than hospital physician lines.
Featured physician rates in New Jersey
Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.
Other states
Medical costs in New Jersey: questions
Across the 59 featured procedures on this page, New Jersey sits above the national average by about 10%. Examples: incision & drainage of abscess $142, skin biopsy (tangential) $106, skin biopsy (punch) $134. Search any other CPT in the box above — those codes are in the tool, not as extra New Jersey articles.
New Jersey has 2 payment localities. Practice-expense GPCI runs from 1.092 to 1.160 (1.000 is the national average). Look up your ZIP code to see whether northern or rest-of-state New Jersey pricing applies, from Newark, Jersey City, and Bergen County down to Trenton, Cherry Hill, and the Jersey 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 New Jersey’s locality when you enter a ZIP.