Medical Procedure Costs in Wisconsin
Wisconsin Medicare physician rates are generally below the national average (-5.4%). One statewide locality, and the ZIP tool still maps you onto it.
Look up any CPT in Wisconsin
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 Wisconsin averages are unweighted means of the state’s localities, not population-weighted.
How Medicare prices Wisconsin
Wisconsin's Medicare pricing runs through a single statewide locality with indices near the national average, so Milwaukee, Madison, and the Northwoods share the same approved amounts. The unified locality sits atop one of the more regionally organized care systems in the country, with strong integrated groups serving defined territories. No metro premium exists in the fee schedule, so Milwaukee's higher practice costs are averaged into the statewide factors. The published rates here travel unchanged across all seventy-two counties.
Milwaukee and Madison hold the state's academic medicine and largest systems, while integrated clinics in Marshfield, La Crosse, and the Fox Valley have long histories of serving rural Wisconsin through hub-and-spoke networks. The far north is lake and forest country where specialty care means a long drive south, and some western residents use Twin Cities or Rochester, Minnesota providers. Wisconsin's tradition of clinic-based integrated care tends to keep billing relatively coordinated.
Check your ZIP code for your part of Wisconsin, whether Milwaukee, Madison, Green Bay and the Fox Valley, La Crosse, Eau Claire, or the rural Northwoods.
Featured physician rates in Wisconsin
Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.
Other states
Medical costs in Wisconsin: questions
Across the 66 featured procedures on this page, Wisconsin sits below the national average by about 5%. Examples: incision & drainage of abscess $122, skin biopsy (tangential) $91, skin biopsy (punch) $115. Search any other CPT in the box above; those codes are in the tool, not as extra Wisconsin articles.
Wisconsin 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 Wisconsin’s locality when you enter a ZIP.