Medical Procedure Costs in Virginia

Virginia Medicare physician rates are generally below the national average (-2.2%). One statewide locality — the ZIP tool still maps you onto that locality.

Look up any CPT in Virginia

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

Try
vs national (featured set)
-2.2%
Medicare localities
1
PE GPCI 0.983
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 Virginia averages are unweighted means of the state’s localities, not population-weighted.

How Medicare prices Virginia

Virginia's physician fees are set through a small number of Medicare payment localities rather than one statewide rate, and the picture is complicated further by the DC locality reaching across the Potomac to cover close-in Northern Virginia suburbs like Arlington and Alexandria at the region's highest adjustments. The rest of the commonwealth, including Richmond, Hampton Roads, and the rural south and west, prices at lower levels through Virginia's own localities. That makes the Northern Virginia line one of the sharper pricing boundaries on the East Coast. Where exactly you sit relative to it is worth confirming.

Virginia's care landscape is regionally distinct: Northern Virginia operates as part of the Washington market, Richmond hosts an academic medical center and large system headquarters, Hampton Roads supports its own dense hospital market, and university medicine anchors Charlottesville. Southwest Virginia's coalfield counties face some of the state's toughest access problems, with some residents using Tennessee providers. Military health facilities add another layer in the Tidewater region.

Check your exact ZIP in Virginia, because Arlington and Alexandria price with Washington while Richmond, Virginia Beach and Hampton Roads, Charlottesville, Roanoke, and the rural southwest do not.

Featured physician rates in Virginia

ProcedureVirginia
Incision & Drainage of Abscess10060$126
Skin Biopsy (Tangential)11102$94
Skin Biopsy (Punch)11104$119
Destruction of Skin Lesion17000$65
Partial Mastectomy19301$604
Total Hip Replacement27130$1,116
Total Knee Replacement27447$1,113
Knee Arthroscopy29881$498
Upper Endoscopy (EGD)43235$316
Upper Endoscopy (EGD) With Biopsy43239$411
Colonoscopy (Diagnostic)45378$370
Colonoscopy With Biopsy45380$470
Colonoscopy With Polyp Removal45385$489
Laparoscopic Cholecystectomy47562$602
Laparoscopic Inguinal Hernia Repair49650$405
Laparoscopic Removal of Ovarian Cyst58661$563
Vaginal Delivery (Global)59400$2,100
Cesarean Delivery (Global)59510$2,334
Lumbar Discectomy63030$854
Cataract Surgery66984$454
MRI Brain Without Contrast70551$192
MRI Brain With Contrast70552$264
MRI Brain70553$311
Chest X-Ray71046$32
CT Chest Without Contrast71250$130
CT Chest With Contrast71260$164
MRI Cervical Spine72141$187
MRI Lumbar Spine72148$188
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$295
Ultrasound Abdomen76700$112
Ultrasound Transvaginal76830$115
Ultrasound Pelvis76856$103
Diagnostic Mammogram77066$154
Screening Mammogram77067$124
Nuclear Stress Test78452$420
Psychiatric Evaluation90791$172
Psychiatric Evaluation With Medical Services90792$199
Psychotherapy (45 min)90834$113
Psychotherapy (60 min)90837$166
ECG/EKG93000$15
Echocardiogram93306$193
Stress Echocardiogram93350$182
Carotid Ultrasound93880$185
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$115
Office Visit (New, Moderate-High)99204$174
Office Visit (New, High)99205$231
Office Visit (Established, Moderate)99213$93
Office Visit (Established, Moderate-High)99214$133
Office Visit (Established, High)99215$189

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

Medical costs in Virginia: questions

Across the 59 featured procedures on this page, Virginia sits below the national average by about 2%. 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 Virginia articles.

Virginia 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 Virginia’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.