Medical Procedure Costs in Virginia
Virginia Medicare physician rates are generally below the national average (-2.2%). One statewide locality, and the ZIP tool still maps you onto it.
Look up any CPT in Virginia
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 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
Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.
Other states
Medical costs in Virginia: questions
Across the 66 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.
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 Virginia’s locality when you enter a ZIP.