Medical Procedure Costs in North Carolina

North Carolina Medicare physician rates are generally below the national average (-5.4%). One statewide locality — the ZIP tool still maps you onto that locality.

Look up any CPT in North Carolina

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

Try
vs national (featured set)
-5.4%
Medicare localities
1
PE GPCI 0.933
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 North Carolina averages are unweighted means of the state’s localities, not population-weighted.

How Medicare prices North Carolina

North Carolina's Medicare physician pricing comes from one statewide locality with indices just under the national average, so Charlotte, the Research Triangle, and the rural east and mountain west all share the same approved amounts. For a state with several fast-growing metros, the single-locality approach keeps the fee schedule simple even as local economies diverge. Nothing in the geographic adjustments distinguishes a Raleigh procedure from one in Boone or Greenville. As elsewhere, the office-versus-hospital setting decision moves prices more than geography within the state does.

North Carolina is unusually rich in academic medicine, with multiple nationally known university medical centers clustered in the Triangle and Winston-Salem, plus a major hospital system anchored in Charlotte that has grown across the Southeast. The rural east and the mountain counties are much thinner markets, and hospital consolidation has been reshaping who owns local care. Patients near the borders sometimes use Virginia or South Carolina providers.

Check your ZIP code for your region of North Carolina, whether Charlotte, Raleigh-Durham and the Triangle, the Triad, Asheville and the mountains, or Wilmington and the coastal east.

Featured physician rates in North Carolina

ProcedureNorth Carolina
Incision & Drainage of Abscess10060$121
Skin Biopsy (Tangential)11102$90
Skin Biopsy (Punch)11104$114
Destruction of Skin Lesion17000$63
Partial Mastectomy19301$587
Total Hip Replacement27130$1,087
Total Knee Replacement27447$1,085
Knee Arthroscopy29881$483
Upper Endoscopy (EGD)43235$303
Upper Endoscopy (EGD) With Biopsy43239$393
Colonoscopy (Diagnostic)45378$356
Colonoscopy With Biopsy45380$451
Colonoscopy With Polyp Removal45385$471
Laparoscopic Cholecystectomy47562$586
Laparoscopic Inguinal Hernia Repair49650$394
Laparoscopic Removal of Ovarian Cyst58661$551
Vaginal Delivery (Global)59400$2,045
Cesarean Delivery (Global)59510$2,272
Lumbar Discectomy63030$826
Cataract Surgery66984$442
MRI Brain Without Contrast70551$185
MRI Brain With Contrast70552$254
MRI Brain70553$299
Chest X-Ray71046$31
CT Chest Without Contrast71250$125
CT Chest With Contrast71260$157
MRI Cervical Spine72141$180
MRI Lumbar Spine72148$181
Shoulder X-Ray73030$34
MRI Shoulder73221$193
Knee X-Ray73560$32
MRI Knee73721$193
CT Abdomen & Pelvis Without Contrast74176$174
CT Abdomen & Pelvis With Contrast74177$283
Ultrasound Abdomen76700$108
Ultrasound Transvaginal76830$111
Ultrasound Pelvis76856$99
Diagnostic Mammogram77066$148
Screening Mammogram77067$119
Nuclear Stress Test78452$401
Psychiatric Evaluation90791$170
Psychiatric Evaluation With Medical Services90792$196
Psychotherapy (45 min)90834$112
Psychotherapy (60 min)90837$164
ECG/EKG93000$15
Echocardiogram93306$186
Stress Echocardiogram93350$175
Carotid Ultrasound93880$177
Laser Treatment for Skin96920$130
Physical Therapy (Therapeutic Exercise)97110$28
Physical Therapy (Manual Therapy)97140$27
PT Evaluation (Low Complexity)97161$95
PT Evaluation (Moderate Complexity)97162$95
Office Visit (New, Low)99203$112
Office Visit (New, Moderate-High)99204$169
Office Visit (New, High)99205$225
Office Visit (Established, Moderate)99213$91
Office Visit (Established, Moderate-High)99214$129
Office Visit (Established, High)99215$184

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

Medical costs in North Carolina: questions

Across the 59 featured procedures on this page, North Carolina sits below the national average by about 5%. Examples: incision & drainage of abscess $121, skin biopsy (tangential) $90, skin biopsy (punch) $114. Search any other CPT in the box above — those codes are in the tool, not as extra North Carolina articles.

North Carolina 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 North Carolina’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.