Medical Procedure Costs in Rhode Island
Rhode Island Medicare physician rates are generally above the national average (+2.2%). One statewide locality, and the ZIP tool still maps you onto it.
Look up any CPT in Rhode Island
Featured table below is 66 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 center 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 Rhode Island averages are unweighted means of the state’s localities, not population-weighted.
How Medicare prices Rhode Island
Rhode Island, the smallest state, is unsurprisingly a single payment locality, with geographic adjustments above the national average in line with southern New England's cost structure. Providence and the shoreline towns publish identical Medicare-approved amounts, and no point in the state is more than an hour from its main hospitals. The compact geography makes locality subdivision pointless. Pricing here reads as a slightly discounted echo of neighboring Boston's market.
Providence dominates Rhode Island care, with the state's teaching hospitals and academic affiliation concentrated there, and consolidation has left a small number of systems running most beds. Many Rhode Islanders, particularly in the northeast corner, use Boston hospitals for complex or specialized procedures, accepting metro Boston pricing when they do. South County residents have fewer local options and often travel to Providence.
Enter a ZIP code for your part of Rhode Island, whether Providence and Pawtucket, Warwick and Cranston, Newport, or the South County shore towns.
Featured physician rates in Rhode Island
Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.
Other states
Medical costs in Rhode Island: questions
Across the 66 featured procedures on this page, Rhode Island sits above the national average by about 2%. Examples: incision & drainage of abscess $132, skin biopsy (tangential) $98, skin biopsy (punch) $124. Search any other CPT in the box above; those codes are in the tool, not as extra Rhode Island articles.
Rhode Island 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.
The table shows Medicare physician allowed amounts in an office: the professional fee after GPCI, which for imaging and other tests done outside a hospital is the full global rate. It does not include hospital facility charges, anesthesia, or your plan’s contracted rate; each procedure page adds the full hospital or surgery center total where CMS pays one. Medicare patients typically owe 20% of the allowed amount after the Part B deductible, before Medigap.
Yes. The table is the featured set (66 procedures). The search box looks up 7,500+ payable codes from the 2026 fee schedule and applies Rhode Island’s locality when you enter a ZIP.