Medicare's 2026 rates in DC + MD/VA Suburbs, District of Columbia
Medicare payment locality 01, run by contractor 12202, covers these counties: District Of Columbia; Alexandria City, Arlington, Fairfax, Fairfax City, Falls Church City In Virginia; Montgomery and Prince George'S In Maryland. Its cost indices put code 99213, billed from an office, at $106.56, 11.9% above the national $95.19.
Cost indices for 2026
- Work (national = 1.000)
- 1.054
- Practice expense (national = 1.000)
- 1.178
- Malpractice (national = 1.000)
- 1.113
- ZIP codes CMS assigns to this locality
- 591
- Of those, split with another locality
- 7
30 common codes priced for DC + MD/VA Suburbs
Physician fee schedule amounts for 2026. Office is what Medicare allows when a doctor's office or clinic bills the code; facility is what it allows a doctor for the same work in a hospital or surgery center.
| Code | Category | Office here | Office national | Facility here |
|---|---|---|---|---|
| 99214 | Visit or care management | $151.49 | $135.61 | $91.29 |
| 99213 | Visit or care management | $106.56 | $95.19 | $62.10 |
| 97110 | Physical therapy or rehabilitation | $32.35 | $29.06 | none |
| 97530 | Physical therapy or rehabilitation | $39.47 | $35.07 | none |
| 97112 | Physical therapy or rehabilitation | $36.47 | $32.73 | none |
| 97140 | Physical therapy or rehabilitation | $30.85 | $27.72 | none |
| 17003 | Skin and soft tissue procedure | $7.31 | $6.35 | $1.80 |
| 88305 | Lab test or pathology | $79.56 | $70.14 | none |
| 93010 | Heart test or procedure | $9.11 | $8.35 | $9.11 |
| 99309 | Visit or care management | $126.70 | $114.57 | $107.82 |
| 99215 | Visit or care management | $214.58 | $192.39 | $135.89 |
| 98941 | Manipulation | $42.37 | $38.41 | $30.17 |
| 71045 | Imaging | $29.11 | $25.38 | none |
| 99204 | Visit or care management | $197.64 | $177.36 | $126.42 |
| 99308 | Visit or care management | $87.30 | $78.83 | $74.31 |
| 93000 | Heart test or procedure | $17.35 | $15.36 | none |
| 92014 | Eye exam or test | $143.94 | $127.26 | $67.22 |
| 99203 | Visit or care management | $131.52 | $117.57 | $77.23 |
| 95004 | Allergy testing or treatment | $4.26 | $3.67 | none |
| 92134 | Eye exam or test | $37.23 | $32.73 | none |
| 96372 | Infusion, injection or chemotherapy | $17.37 | $15.36 | none |
| 99490 | Visit or care management | $73.61 | $66.13 | $47.25 |
| 90837 | Mental health service | $181.03 | $167.00 | $143.65 |
| 93306 | Heart test or procedure | $225.69 | $196.73 | none |
| 99212 | Visit or care management | $67.01 | $59.45 | $33.56 |
| 71046 | Imaging | $38.04 | $33.07 | none |
| 17000 | Skin and soft tissue procedure | $75.73 | $66.47 | $53.69 |
| 77067 | Imaging | $145.56 | $126.26 | none |
| 95165 | Allergy testing or treatment | $20.19 | $17.37 | $2.88 |
| 77063 | Imaging | $57.69 | $51.10 | none |
Hospital outpatient rates and lab fee schedule amounts are national, so they are the same here as everywhere; each code page lists them.