Cost analysis for CPT 99203 — New patient office or other outpatient visit, typically 30 minutes
Average Medicare Payment
$70.14
2023 data
Total Payments (2023)
$594.8M
Services (2023)
8.3M
Price Change (2014–2023)
+0.6%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $69.71 | $694.2M | 9.7M | — |
| 2015 | $69.91 | $721.9M | 10.0M | +0.3% |
| 2016 | $68.11 | $727.2M | 10.3M | -2.6% |
| 2017 | $67.43 | $720.3M | 10.3M | -1.0% |
| 2018 | $67.56 | $721.1M | 10.3M | +0.2% |
| 2019 | $68.71 | $743.3M | 10.4M | +1.7% |
| 2020 | $68.49 | $599.9M | 8.4M | -0.3% |
| 2021 | $74.75 | $696.0M | 9.0M | +9.1% |
| 2022 | $71.96 | $641.4M | 8.7M | -3.7% |
| 2023 | $70.14 | $594.8M | 8.3M | -2.5% |
The most expensive state pays 1.5x more than the cheapest for this procedure. NY averages $86.56 vs VT at $57.05.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| NY | $86.56 | $53.0M | 612.8K | 11.4K |
| AK | $85.56 | $1.9M | 22.6K | 432 |
| XX | $85.21 | $24.4K | 286 | 2 |
| NJ | $83.25 | $27.3M | 328.0K | 5.7K |
| DC | $81.19 | $1.6M | 20.0K | 428 |
| CA | $79.14 | $58.2M | 735.3K | 12.7K |
| CT | $78.05 | $7.9M | 101.4K | 2.2K |
| MD | $77.60 | $18.1M | 232.9K | 3.6K |
| MA | $76.29 | $17.6M | 230.6K | 4.3K |
| RI | $73.88 | $2.1M | 28.1K | 583 |
| IL | $73.36 | $23.3M | 317.4K | 6.2K |
| DE | $72.92 | $3.5M | 48.5K | 668 |
| PR | $72.85 | $867.0K | 11.9K | 475 |
| FL | $72.01 | $52.1M | 723.9K | 11.7K |
| PA | $71.78 | $25.3M | 352.9K | 7.3K |
| HI | $71.63 | $1.6M | 22.2K | 446 |
| VA | $71.21 | $18.7M | 262.8K | 4.9K |
| CO | $70.97 | $8.3M | 117.2K | 2.7K |
| NV | $70.76 | $5.2M | 73.2K | 1.4K |
| WA | $70.03 | $10.4M | 148.3K | 3.1K |
| MI | $69.84 | $13.7M | 196.7K | 4.6K |
| MN | $69.57 | $6.3M | 89.9K | 2.7K |
| TX | $69.55 | $37.2M | 535.2K | 10.8K |
| GA | $69.05 | $17.6M | 255.4K | 5.3K |
| AE | $68.27 | $15.0K | 219 | 6 |
| NH | $68.06 | $3.3M | 49.0K | 1.0K |
| GU | $67.88 | $91.4K | 1.3K | 36 |
| LA | $67.78 | $6.4M | 93.9K | 2.1K |
| OR | $67.19 | $5.3M | 79.5K | 1.8K |
| UT | $67.12 | $3.6M | 54.0K | 1.4K |
| SC | $67.00 | $11.6M | 172.7K | 3.0K |
| AZ | $66.73 | $16.6M | 248.8K | 4.1K |
| MO | $66.32 | $9.6M | 144.1K | 3.0K |
| AL | $66.22 | $6.9M | 104.8K | 2.2K |
| NC | $66.15 | $16.7M | 251.9K | 5.4K |
| WY | $65.77 | $1.3M | 19.2K | 378 |
| IN | $65.71 | $11.0M | 167.2K | 3.5K |
| OK | $65.69 | $6.6M | 100.1K | 1.9K |
| OH | $65.51 | $18.2M | 278.3K | 6.4K |
| KY | $65.42 | $7.0M | 106.6K | 2.4K |
| MT | $65.39 | $2.2M | 33.5K | 695 |
| TN | $65.35 | $11.6M | 177.0K | 3.7K |
| KS | $64.86 | $5.3M | 81.0K | 1.5K |
| WI | $64.64 | $6.9M | 106.8K | 2.8K |
| IA | $64.64 | $5.2M | 79.7K | 1.6K |
| NM | $64.42 | $2.8M | 44.1K | 870 |
| MS | $63.72 | $5.1M | 79.9K | 1.5K |
| NE | $63.05 | $3.4M | 54.2K | 1.0K |
| SD | $62.95 | $1.8M | 27.9K | 604 |
| VI | $62.92 | $122.8K | 2.0K | 32 |
| AR | $62.92 | $5.7M | 90.1K | 1.6K |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Adam Moskowitz | Gastroenterology | NY | $107.7K | 1.6K | $66.12 |
| Michael Mcginnis | Pathology | CA | $106.4K | 908 | $117.15 |
| Gregory Rubin | Sports Medicine | FL | $102.8K | 1.3K | $79.39 |
| Wesley Thek | Emergency Medicine | NJ | $97.2K | 1.1K | $88.25 |
| Robert Buka | Dermatology | NY | $95.6K | 1.1K | $90.24 |
| Nikol Ilyasov | Physician Assistant | NY | $94.2K | 1.1K | $89.32 |
| Eric Sorensen | Family Practice | CA | $92.9K | 1.2K | $76.86 |
| Samuel Williams | Internal Medicine | GA | $89.5K | 1.4K | $61.88 |
| Dinesh Verma | Pulmonary Disease | CA | $88.9K | 984 | $90.31 |
| Ralph Bassett | Otolaryngology | AZ | $88.4K | 1.2K | $75.88 |
| Joseph Zaladonis | Dermatology | PA | $87.8K | 1.2K | $73.64 |
| Roy Musoff | Internal Medicine | FL | $86.4K | 1.1K | $77.05 |
| Raffi-Jean Mesrobian | Otolaryngology | CA | $82.1K | 948 | $86.61 |
| Benjamin Tehrani | Podiatry | CA | $81.1K | 857 | $94.59 |
| Jonathan Hinds | General Practice | FL | $81.0K | 1.1K | $76.86 |
| Surya Reddy | Family Practice | CA | $78.8K | 983 | $80.16 |
| David Kasper | Dermatology | PA | $76.0K | 934 | $81.41 |
| Brandon Oconnor | Family Practice | NY | $75.4K | 971 | $77.66 |
| Leah Bush | Nurse Practitioner | AL | $75.1K | 1.1K | $68.02 |
| Sohail Shayfer | Orthopedic Surgery | CA | $74.6K | 824 | $90.59 |
Based on the data, CPT 99203 shows a 1.5x variation in pricing across states — moderate variation by Medicare standards.
Costs have increased 0.6% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.