Medical Procedure Costs in Vermont

Vermont Medicare physician rates are generally below the national average (-2.6%). One statewide locality — the ZIP tool still maps you onto that locality.

Look up any CPT in Vermont

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

Try
vs national (featured set)
-2.6%
Medicare localities
1
PE GPCI 0.990
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 Vermont averages are unweighted means of the state’s localities, not population-weighted.

How Medicare prices Vermont

Vermont, with the second-smallest population in the country, is priced as one statewide locality with indices close to the national average, higher than northern New England's rural profile might suggest. Burlington and the smallest Northeast Kingdom towns share the same Medicare-approved amounts. No subdivision has ever been warranted for a state without a single large metro. The fee schedule's simplicity contrasts with the real-world challenge of delivering specialty care across the Green Mountains.

The state's academic medical center in Burlington handles most complex care and also serves northern New York across Lake Champlain, while community hospitals cover the rest of the state with limited procedure menus. Vermonters in the south and east regularly use Dartmouth-area or Boston providers over the border. An aging population, among the oldest in the nation, keeps Medicare central to the state's health economy.

Enter a ZIP code for your part of Vermont, whether Burlington and Chittenden County, Montpelier, Rutland, Brattleboro, or the Northeast Kingdom.

Featured physician rates in Vermont

ProcedureVermont
Incision & Drainage of Abscess10060$126
Skin Biopsy (Tangential)11102$94
Skin Biopsy (Punch)11104$119
Destruction of Skin Lesion17000$65
Partial Mastectomy19301$589
Total Hip Replacement27130$1,091
Total Knee Replacement27447$1,089
Knee Arthroscopy29881$490
Upper Endoscopy (EGD)43235$316
Upper Endoscopy (EGD) With Biopsy43239$411
Colonoscopy (Diagnostic)45378$369
Colonoscopy With Biopsy45380$470
Colonoscopy With Polyp Removal45385$488
Laparoscopic Cholecystectomy47562$586
Laparoscopic Inguinal Hernia Repair49650$396
Laparoscopic Removal of Ovarian Cyst58661$550
Vaginal Delivery (Global)59400$2,034
Cesarean Delivery (Global)59510$2,252
Lumbar Discectomy63030$831
Cataract Surgery66984$452
MRI Brain Without Contrast70551$192
MRI Brain With Contrast70552$265
MRI Brain70553$312
Chest X-Ray71046$32
CT Chest Without Contrast71250$130
CT Chest With Contrast71260$164
MRI Cervical Spine72141$188
MRI Lumbar Spine72148$189
Shoulder X-Ray73030$35
MRI Shoulder73221$202
Knee X-Ray73560$34
MRI Knee73721$201
CT Abdomen & Pelvis Without Contrast74176$180
CT Abdomen & Pelvis With Contrast74177$296
Ultrasound Abdomen76700$112
Ultrasound Transvaginal76830$116
Ultrasound Pelvis76856$104
Diagnostic Mammogram77066$154
Screening Mammogram77067$124
Nuclear Stress Test78452$422
Psychiatric Evaluation90791$173
Psychiatric Evaluation With Medical Services90792$199
Psychotherapy (45 min)90834$113
Psychotherapy (60 min)90837$166
ECG/EKG93000$15
Echocardiogram93306$194
Stress Echocardiogram93350$183
Carotid Ultrasound93880$186
Laser Treatment for Skin96920$136
Physical Therapy (Therapeutic Exercise)97110$29
Physical Therapy (Manual Therapy)97140$27
PT Evaluation (Low Complexity)97161$97
PT Evaluation (Moderate Complexity)97162$97
Office Visit (New, Low)99203$114
Office Visit (New, Moderate-High)99204$173
Office Visit (New, High)99205$230
Office Visit (Established, Moderate)99213$93
Office Visit (Established, Moderate-High)99214$133
Office Visit (Established, High)99215$188

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

Medical costs in Vermont: questions

Across the 59 featured procedures on this page, Vermont sits below the national average by about 3%. Examples: incision & drainage of abscess $126, skin biopsy (tangential) $94, skin biopsy (punch) $119. Search any other CPT in the box above — those codes are in the tool, not as extra Vermont articles.

Vermont 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 Vermont’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.