Medical Procedure Costs in Washington
Washington Medicare physician rates are generally above the national average (+8.6%). CMS uses 2 localities here, so a ZIP matters.
Look up any CPT in Washington
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 Washington averages are unweighted means of the state’s localities, not population-weighted.
How Medicare prices Washington
Washington divides into a Seattle-area locality and a rest-of-state locality, so Puget Sound's biggest market carries higher geographic adjustments than Spokane, the Tri-Cities, or the coast. The Seattle locality reflects some of the highest wages in the western United States, while everywhere else in the state shares one lower-cost set of factors. An identical procedure is therefore approved at more in Seattle than in Spokane, a two-tier pattern much like Oregon's. Rest-of-state Washington still prices respectably against national averages.
Seattle is the referral capital of the Pacific Northwest, with academic medicine that serves not just Washington but Alaska, Montana, Idaho, and Wyoming through long-standing regional arrangements. Spokane anchors the Inland Northwest, drawing patients from northern Idaho and beyond, while the Olympic Peninsula and southwest coast are comparatively underserved. Rapid consolidation has concentrated much of the state's care into a few large systems.
Enter your ZIP code to see whether Seattle-area or rest-of-state pricing applies, from Seattle, Tacoma, and Everett to Spokane, the Tri-Cities, Vancouver, Bellingham, and the Olympic Peninsula.
Washington payment localities (GPCI)
| Locality | Work | PE |
|---|---|---|
| seattle (king cnty) | 1.050 | 1.227 |
| rest of washington | 1.013 | 1.053 |
GPCI of 1.000 equals the national average. Higher PE GPCI raises office-based procedures more than hospital physician lines.
Featured physician rates in Washington
Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.
Other states
Medical costs in Washington: questions
Across the 59 featured procedures on this page, Washington sits above the national average by about 9%. Examples: incision & drainage of abscess $141, skin biopsy (tangential) $106, skin biopsy (punch) $134. Search any other CPT in the box above — those codes are in the tool, not as extra Washington articles.
Washington has 2 payment localities. Practice-expense GPCI runs from 1.053 to 1.227 (1.000 is the national average). Enter your ZIP code to see whether Seattle-area or rest-of-state pricing applies, from Seattle, Tacoma, and Everett to Spokane, the Tri-Cities, Vancouver, Bellingham, and the Olympic Peninsula.
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 Washington’s locality when you enter a ZIP.