Medicare's 2026 rates in NYC Suburbs/Long Island, New York
Medicare payment locality 02, run by contractor 13202, covers these counties: Bronx, Kings, Nassau, Richmond, Rockland, Suffolk and Westchester. Its cost indices put code 99213, billed from an office, at $109.76, 15.3% above the national $95.19.
Cost indices for 2026
- Work (national = 1.000)
- 1.064
- Practice expense (national = 1.000)
- 1.189
- Malpractice (national = 1.000)
- 1.857
- ZIP codes CMS assigns to this locality
- 440
- Of those, split with another locality
- 5
30 common codes priced for NYC Suburbs/Long Island
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 | $156.34 | $135.61 | $95.58 |
| 99213 | Visit or care management | $109.76 | $95.19 | $64.89 |
| 97110 | Physical therapy or rehabilitation | $32.90 | $29.06 | none |
| 97530 | Physical therapy or rehabilitation | $40.09 | $35.07 | none |
| 97112 | Physical therapy or rehabilitation | $37.05 | $32.73 | none |
| 97140 | Physical therapy or rehabilitation | $31.39 | $27.72 | none |
| 17003 | Skin and soft tissue procedure | $7.38 | $6.35 | $1.82 |
| 88305 | Lab test or pathology | $80.80 | $70.14 | none |
| 93010 | Heart test or procedure | $9.44 | $8.35 | $9.44 |
| 99309 | Visit or care management | $131.33 | $114.57 | $112.26 |
| 99215 | Visit or care management | $221.75 | $192.39 | $142.32 |
| 98941 | Manipulation | $43.01 | $38.41 | $30.70 |
| 71045 | Imaging | $29.88 | $25.38 | none |
| 99204 | Visit or care management | $205.38 | $177.36 | $133.50 |
| 99308 | Visit or care management | $90.08 | $78.83 | $76.98 |
| 93000 | Heart test or procedure | $18.00 | $15.36 | none |
| 92014 | Eye exam or test | $146.27 | $127.26 | $68.83 |
| 99203 | Visit or care management | $136.68 | $117.57 | $81.88 |
| 95004 | Allergy testing or treatment | $4.55 | $3.67 | none |
| 92134 | Eye exam or test | $38.07 | $32.73 | none |
| 96372 | Infusion, injection or chemotherapy | $17.78 | $15.36 | none |
| 99490 | Visit or care management | $76.02 | $66.13 | $49.41 |
| 90837 | Mental health service | $183.23 | $167.00 | $145.50 |
| 93306 | Heart test or procedure | $229.77 | $196.73 | none |
| 99212 | Visit or care management | $69.11 | $59.45 | $35.35 |
| 71046 | Imaging | $38.89 | $33.07 | none |
| 17000 | Skin and soft tissue procedure | $77.91 | $66.47 | $55.67 |
| 77067 | Imaging | $148.14 | $126.26 | none |
| 95165 | Allergy testing or treatment | $20.62 | $17.37 | $3.15 |
| 77063 | Imaging | $58.97 | $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.