Medicare's 2026 rates in Rest of Massachusetts, Massachusetts
Medicare payment locality 99, run by contractor 14212, covers every county in Massachusetts not in another locality. Its cost indices put code 99213, billed from an office, at $97.86, 2.8% above the national $95.19.
Cost indices for 2026
- Work (national = 1.000)
- 1.016
- Practice expense (national = 1.000)
- 1.053
- Malpractice (national = 1.000)
- 0.797
- ZIP codes CMS assigns to this locality
- 494
- Of those, split with another locality
- 2
30 common codes priced for Rest of Massachusetts
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 | $139.22 | $135.61 | $85.41 |
| 99213 | Visit or care management | $97.86 | $95.19 | $58.12 |
| 97110 | Physical therapy or rehabilitation | $29.96 | $29.06 | none |
| 97530 | Physical therapy or rehabilitation | $36.30 | $35.07 | none |
| 97112 | Physical therapy or rehabilitation | $33.76 | $32.73 | none |
| 97140 | Physical therapy or rehabilitation | $28.58 | $27.72 | none |
| 17003 | Skin and soft tissue procedure | $6.63 | $6.35 | $1.71 |
| 88305 | Lab test or pathology | $72.79 | $70.14 | none |
| 93010 | Heart test or procedure | $8.50 | $8.35 | $8.50 |
| 99309 | Visit or care management | $117.07 | $114.57 | $100.18 |
| 99215 | Visit or care management | $197.33 | $192.39 | $126.99 |
| 98941 | Manipulation | $39.51 | $38.41 | $28.61 |
| 71045 | Imaging | $26.34 | $25.38 | none |
| 99204 | Visit or care management | $181.49 | $177.36 | $117.83 |
| 99308 | Visit or care management | $80.71 | $78.83 | $69.11 |
| 93000 | Heart test or procedure | $15.80 | $15.36 | none |
| 92014 | Eye exam or test | $131.91 | $127.26 | $63.32 |
| 99203 | Visit or care management | $120.46 | $117.57 | $71.92 |
| 95004 | Allergy testing or treatment | $3.77 | $3.67 | none |
| 92134 | Eye exam or test | $33.91 | $32.73 | none |
| 96372 | Infusion, injection or chemotherapy | $15.88 | $15.36 | none |
| 99490 | Visit or care management | $67.80 | $66.13 | $44.24 |
| 90837 | Mental health service | $171.01 | $167.00 | $137.60 |
| 93306 | Heart test or procedure | $204.72 | $196.73 | none |
| 99212 | Visit or care management | $61.23 | $59.45 | $31.33 |
| 71046 | Imaging | $34.39 | $33.07 | none |
| 17000 | Skin and soft tissue procedure | $68.75 | $66.47 | $49.05 |
| 77067 | Imaging | $131.60 | $126.26 | none |
| 95165 | Allergy testing or treatment | $18.13 | $17.37 | $2.65 |
| 77063 | Imaging | $52.83 | $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.