Medicare's 2026 rates in Houston, Texas
Medicare payment locality 18, run by contractor 04412, covers these counties: Harris. Its cost indices put code 99213, billed from an office, at $96.33, 1.2% above the national $95.19.
Cost indices for 2026
- Work (national = 1.000)
- 1.008
- Practice expense (national = 1.000)
- 0.993
- Malpractice (national = 1.000)
- 1.376
- ZIP codes CMS assigns to this locality
- 243
- Of those, split with another locality
- 12
30 common codes priced for Houston
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 | $137.41 | $135.61 | $86.67 |
| 99213 | Visit or care management | $96.33 | $95.19 | $58.85 |
| 97110 | Physical therapy or rehabilitation | $29.21 | $29.06 | none |
| 97530 | Physical therapy or rehabilitation | $35.17 | $35.07 | none |
| 97112 | Physical therapy or rehabilitation | $32.88 | $32.73 | none |
| 97140 | Physical therapy or rehabilitation | $27.87 | $27.72 | none |
| 17003 | Skin and soft tissue procedure | $6.32 | $6.35 | $1.68 |
| 88305 | Lab test or pathology | $70.27 | $70.14 | none |
| 93010 | Heart test or procedure | $8.50 | $8.35 | $8.50 |
| 99309 | Visit or care management | $116.52 | $114.57 | $100.60 |
| 99215 | Visit or care management | $195.13 | $192.39 | $128.80 |
| 98941 | Manipulation | $38.62 | $38.41 | $28.33 |
| 71045 | Imaging | $25.55 | $25.38 | none |
| 99204 | Visit or care management | $180.49 | $177.36 | $120.46 |
| 99308 | Visit or care management | $79.95 | $78.83 | $69.00 |
| 93000 | Heart test or procedure | $15.60 | $15.36 | none |
| 92014 | Eye exam or test | $127.59 | $127.26 | $62.91 |
| 99203 | Visit or care management | $119.60 | $117.57 | $73.83 |
| 95004 | Allergy testing or treatment | $3.78 | $3.67 | none |
| 92134 | Eye exam or test | $32.91 | $32.73 | none |
| 96372 | Infusion, injection or chemotherapy | $15.47 | $15.36 | none |
| 99490 | Visit or care management | $67.07 | $66.13 | $44.85 |
| 90837 | Mental health service | $167.99 | $167.00 | $136.48 |
| 93306 | Heart test or procedure | $197.09 | $196.73 | none |
| 99212 | Visit or care management | $60.16 | $59.45 | $31.96 |
| 71046 | Imaging | $33.20 | $33.07 | none |
| 17000 | Skin and soft tissue procedure | $67.07 | $66.47 | $48.49 |
| 77067 | Imaging | $126.38 | $126.26 | none |
| 95165 | Allergy testing or treatment | $17.40 | $17.37 | $2.81 |
| 77063 | Imaging | $51.43 | $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.