Medicare's 2026 rates in Metropolitan Boston, Massachusetts
Medicare payment locality 01, run by contractor 14212, covers these counties: Middlesex, Norfolk and Suffolk. Its cost indices put code 99213, billed from an office, at $106.10, 11.5% above the national $95.19.
Cost indices for 2026
- Work (national = 1.000)
- 1.041
- Practice expense (national = 1.000)
- 1.194
- Malpractice (national = 1.000)
- 0.890
- ZIP codes CMS assigns to this locality
- 258
- Of those, split with another locality
- 1
30 common codes priced for Metropolitan Boston
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 | $150.68 | $135.61 | $89.66 |
| 99213 | Visit or care management | $106.10 | $95.19 | $61.04 |
| 97110 | Physical therapy or rehabilitation | $32.29 | $29.06 | none |
| 97530 | Physical therapy or rehabilitation | $39.52 | $35.07 | none |
| 97112 | Physical therapy or rehabilitation | $36.43 | $32.73 | none |
| 97140 | Physical therapy or rehabilitation | $30.80 | $27.72 | none |
| 17003 | Skin and soft tissue procedure | $7.37 | $6.35 | $1.79 |
| 88305 | Lab test or pathology | $79.82 | $70.14 | none |
| 93010 | Heart test or procedure | $9.00 | $8.35 | $9.00 |
| 99309 | Visit or care management | $125.56 | $114.57 | $106.41 |
| 99215 | Visit or care management | $213.27 | $192.39 | $133.51 |
| 98941 | Manipulation | $42.24 | $38.41 | $29.87 |
| 71045 | Imaging | $29.19 | $25.38 | none |
| 99204 | Visit or care management | $196.04 | $177.36 | $123.86 |
| 99308 | Visit or care management | $86.66 | $78.83 | $73.50 |
| 93000 | Heart test or procedure | $17.27 | $15.36 | none |
| 92014 | Eye exam or test | $144.28 | $127.26 | $66.52 |
| 99203 | Visit or care management | $130.58 | $117.57 | $75.54 |
| 95004 | Allergy testing or treatment | $4.23 | $3.67 | none |
| 92134 | Eye exam or test | $37.30 | $32.73 | none |
| 96372 | Infusion, injection or chemotherapy | $17.37 | $15.36 | none |
| 99490 | Visit or care management | $73.14 | $66.13 | $46.42 |
| 90837 | Mental health service | $179.88 | $167.00 | $142.00 |
| 93306 | Heart test or procedure | $226.83 | $196.73 | none |
| 99212 | Visit or care management | $66.80 | $59.45 | $32.90 |
| 71046 | Imaging | $38.21 | $33.07 | none |
| 17000 | Skin and soft tissue procedure | $75.74 | $66.47 | $53.41 |
| 77067 | Imaging | $146.46 | $126.26 | none |
| 95165 | Allergy testing or treatment | $20.33 | $17.37 | $2.78 |
| 77063 | Imaging | $57.70 | $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.