Medical Procedure Costs in Texas
Texas Medicare physician rates are generally near the national average. CMS uses 8 localities here, so a ZIP matters.
Look up any CPT in Texas
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 Texas averages are unweighted means of the state’s localities, not population-weighted.
How Medicare prices Texas
Texas is carved into grouped metro localities rather than priced statewide: Houston, Dallas, Fort Worth, Austin, Galveston, Beaumont, and Brazoria each carry their own locality, and the enormous remainder of the state shares rest-of-state pricing. The big-city localities approve higher amounts than rural Texas, with Houston and Dallas at the top of the state's range. Uniquely, several smaller Gulf Coast areas kept their own localities from an earlier era, which is why Galveston and Beaumont are priced separately from Houston. San Antonio and El Paso, despite their size, fall under rest-of-state factors.
Texas contains several of the largest medical complexes in the world, most famously in Houston, plus deep hospital markets in Dallas-Fort Worth, San Antonio, and Austin. At the other extreme, West Texas and the Panhandle include counties with no physician at all, and rural hospital closures have hit Texas harder than almost any state. Border communities from El Paso to the Rio Grande Valley have distinct markets, and some residents cross into Mexico for lower-cost dental and pharmacy care.
With so many Texas localities, check your exact ZIP: Houston, Dallas-Fort Worth, Austin, the Galveston and Beaumont coast, San Antonio, El Paso, the Valley, and rural West Texas can all price differently.
Texas payment localities (GPCI)
| Locality | Work | PE |
|---|---|---|
| austin | 1.002 | 1.058 |
| beaumont | 1.000 | 0.910 |
| brazoria | 1.008 | 0.991 |
| dallas | 1.009 | 0.996 |
| fort worth | 1.009 | 0.986 |
| galveston | 1.008 | 0.993 |
| houston | 1.008 | 0.993 |
| rest of texas | 1.000 | 0.949 |
GPCI of 1.000 equals the national average. Higher PE GPCI raises office-based procedures more than hospital physician lines.
Featured physician rates in Texas
Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.
Other states
Medical costs in Texas: questions
Across the 59 featured procedures on this page, Texas sits near the national average. Examples: incision & drainage of abscess $127, skin biopsy (tangential) $94, skin biopsy (punch) $120. Search any other CPT in the box above — those codes are in the tool, not as extra Texas articles.
Texas has 8 payment localities. Practice-expense GPCI runs from 0.910 to 1.058 (1.000 is the national average). With so many Texas localities, check your exact ZIP: Houston, Dallas-Fort Worth, Austin, the Galveston and Beaumont coast, San Antonio, El Paso, the Valley, and rural West Texas can all price differently.
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 Texas’s locality when you enter a ZIP.