Medical Procedure Costs in West Virginia

West Virginia Medicare physician rates are generally below the national average (-6.1%). One statewide locality — the ZIP tool still maps you onto that locality.

Look up any CPT in West Virginia

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

Try
vs national (featured set)
-6.1%
Medicare localities
1
PE GPCI 0.869
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 West Virginia averages are unweighted means of the state’s localities, not population-weighted.

How Medicare prices West Virginia

West Virginia is one statewide payment locality with geographic indices among the lowest in the eastern United States, so its published Medicare rates apply identically from the Eastern Panhandle to the southern coalfields. The uniform pricing spans a state whose mountainous terrain makes actual travel to care unusually difficult relative to straight-line distances. CMS's work index floor supports the state's low-cost profile. Morgantown, Charleston, and Huntington all bill against the same geographic factors.

The state's care concentrates around its academic medical centers in Morgantown and Huntington and the capital-region hospitals in Charleston, each serving long mountain catchments. West Virginia's population is among the oldest and highest-need in the country, and hospital finances have been fragile in many counties. Eastern Panhandle residents commonly use Maryland or Virginia providers, and northern residents look to Pittsburgh.

Run a ZIP lookup for your part of West Virginia, whether Morgantown, Charleston, Huntington, Wheeling, the Eastern Panhandle near Martinsburg, or the southern coalfields.

Featured physician rates in West Virginia

ProcedureWest Virginia
Incision & Drainage of Abscess10060$119
Skin Biopsy (Tangential)11102$87
Skin Biopsy (Punch)11104$111
Destruction of Skin Lesion17000$61
Partial Mastectomy19301$641
Total Hip Replacement27130$1,169
Total Knee Replacement27447$1,167
Knee Arthroscopy29881$504
Upper Endoscopy (EGD)43235$294
Upper Endoscopy (EGD) With Biopsy43239$379
Colonoscopy (Diagnostic)45378$350
Colonoscopy With Biopsy45380$440
Colonoscopy With Polyp Removal45385$464
Laparoscopic Cholecystectomy47562$644
Laparoscopic Inguinal Hernia Repair49650$426
Laparoscopic Removal of Ovarian Cyst58661$598
Vaginal Delivery (Global)59400$2,284
Cesarean Delivery (Global)59510$2,573
Lumbar Discectomy63030$904
Cataract Surgery66984$444
MRI Brain Without Contrast70551$178
MRI Brain With Contrast70552$244
MRI Brain70553$288
Chest X-Ray71046$30
CT Chest Without Contrast71250$121
CT Chest With Contrast71260$151
MRI Cervical Spine72141$174
MRI Lumbar Spine72148$175
Shoulder X-Ray73030$32
MRI Shoulder73221$186
Knee X-Ray73560$31
MRI Knee73721$185
CT Abdomen & Pelvis Without Contrast74176$169
CT Abdomen & Pelvis With Contrast74177$271
Ultrasound Abdomen76700$104
Ultrasound Transvaginal76830$106
Ultrasound Pelvis76856$95
Diagnostic Mammogram77066$142
Screening Mammogram77067$114
Nuclear Stress Test78452$381
Psychiatric Evaluation90791$168
Psychiatric Evaluation With Medical Services90792$197
Psychotherapy (45 min)90834$111
Psychotherapy (60 min)90837$162
ECG/EKG93000$14
Echocardiogram93306$179
Stress Echocardiogram93350$169
Carotid Ultrasound93880$170
Laser Treatment for Skin96920$124
Physical Therapy (Therapeutic Exercise)97110$27
Physical Therapy (Manual Therapy)97140$26
PT Evaluation (Low Complexity)97161$92
PT Evaluation (Moderate Complexity)97162$92
Office Visit (New, Low)99203$112
Office Visit (New, Moderate-High)99204$170
Office Visit (New, High)99205$228
Office Visit (Established, Moderate)99213$90
Office Visit (Established, Moderate-High)99214$129
Office Visit (Established, High)99215$183

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

Medical costs in West Virginia: questions

Across the 59 featured procedures on this page, West Virginia sits below the national average by about 6%. Examples: incision & drainage of abscess $119, skin biopsy (tangential) $87, skin biopsy (punch) $111. Search any other CPT in the box above — those codes are in the tool, not as extra West Virginia articles.

West 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 West 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.