OpenMedicare
Start Here
Explore
Fraud
Investigations
Data
Tools
About

Footer

OpenMedicare

Independent Medicare data journalism

Sister Sites

  • OpenMedicaid
  • OpenFeds
  • OpenSpending

Explore

  • Providers
  • Procedures
  • States
  • Specialties
  • Search

Fraud Analysis

  • Still Out There (AI)
  • Fraud Overview
  • Fraud Watchlist
  • Deep Dive Profiles
  • Impossible Numbers
  • Report Fraud

Investigations

  • The Algorithm Knows
  • How We Built the Model
  • Internal Medicine Crisis
  • Florida & California Fraud
  • Million Dollar Flagged
  • All Investigations

Tools

  • Provider Lookup
  • Compare
  • Cost Calculator
  • Your Medicare Dollar
  • Downloads

About

  • About OpenMedicare
  • Methodology
  • Glossary
  • Data Sources
  • API Docs
  • Updates
Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
Sister Sites: OpenMedicaid · OpenFeds · OpenSpending

© 2026 OpenMedicare. Independent data journalism. Built by TheDataProject.ai

Methodology•Download Data
  1. Home
  2. Procedures
  3. 99203
  4. Cost Analysis

How Much Does New patient office or other outpatient visit, typically 30 minutes Cost on Medicare?

Cost analysis for CPT 99203 — New patient office or other outpatient visit, typically 30 minutes

Share:

Average Medicare Payment

$70.14

2023 data

Total Payments (2023)

$594.8M

Services (2023)

8.3M

Price Change (2014–2023)

+0.6%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2014$69.71$694.2M9.7M—
2015$69.91$721.9M10.0M+0.3%
2016$68.11$727.2M10.3M-2.6%
2017$67.43$720.3M10.3M-1.0%
2018$67.56$721.1M10.3M+0.2%
2019$68.71$743.3M10.4M+1.7%
2020$68.49$599.9M8.4M-0.3%
2021$74.75$696.0M9.0M+9.1%
2022$71.96$641.4M8.7M-3.7%
2023$70.14$594.8M8.3M-2.5%

🗺️ State-by-State Cost Variation

The most expensive state pays 1.5x more than the cheapest for this procedure. NY averages $86.56 vs VT at $57.05.

StateAvg PaymentTotal PaymentsServicesProviders
NY$86.56$53.0M612.8K11.4K
AK$85.56$1.9M22.6K432
XX$85.21$24.4K2862
NJ$83.25$27.3M328.0K5.7K
DC$81.19$1.6M20.0K428
CA$79.14$58.2M735.3K12.7K
CT$78.05$7.9M101.4K2.2K
MD$77.60$18.1M232.9K3.6K
MA$76.29$17.6M230.6K4.3K
RI$73.88$2.1M28.1K583
IL$73.36$23.3M317.4K6.2K
DE$72.92$3.5M48.5K668
PR$72.85$867.0K11.9K475
FL$72.01$52.1M723.9K11.7K
PA$71.78$25.3M352.9K7.3K
HI$71.63$1.6M22.2K446
VA$71.21$18.7M262.8K4.9K
CO$70.97$8.3M117.2K2.7K
NV$70.76$5.2M73.2K1.4K
WA$70.03$10.4M148.3K3.1K
MI$69.84$13.7M196.7K4.6K
MN$69.57$6.3M89.9K2.7K
TX$69.55$37.2M535.2K10.8K
GA$69.05$17.6M255.4K5.3K
AE$68.27$15.0K2196
NH$68.06$3.3M49.0K1.0K
GU$67.88$91.4K1.3K36
LA$67.78$6.4M93.9K2.1K
OR$67.19$5.3M79.5K1.8K
UT$67.12$3.6M54.0K1.4K
SC$67.00$11.6M172.7K3.0K
AZ$66.73$16.6M248.8K4.1K
MO$66.32$9.6M144.1K3.0K
AL$66.22$6.9M104.8K2.2K
NC$66.15$16.7M251.9K5.4K
WY$65.77$1.3M19.2K378
IN$65.71$11.0M167.2K3.5K
OK$65.69$6.6M100.1K1.9K
OH$65.51$18.2M278.3K6.4K
KY$65.42$7.0M106.6K2.4K
MT$65.39$2.2M33.5K695
TN$65.35$11.6M177.0K3.7K
KS$64.86$5.3M81.0K1.5K
WI$64.64$6.9M106.8K2.8K
IA$64.64$5.2M79.7K1.6K
NM$64.42$2.8M44.1K870
MS$63.72$5.1M79.9K1.5K
NE$63.05$3.4M54.2K1.0K
SD$62.95$1.8M27.9K604
VI$62.92$122.8K2.0K32
AR$62.92$5.7M90.1K1.6K

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Adam MoskowitzGastroenterologyNY$107.7K1.6K$66.12
Michael McginnisPathologyCA$106.4K908$117.15
Gregory RubinSports MedicineFL$102.8K1.3K$79.39
Wesley ThekEmergency MedicineNJ$97.2K1.1K$88.25
Robert BukaDermatologyNY$95.6K1.1K$90.24
Nikol IlyasovPhysician AssistantNY$94.2K1.1K$89.32
Eric SorensenFamily PracticeCA$92.9K1.2K$76.86
Samuel WilliamsInternal MedicineGA$89.5K1.4K$61.88
Dinesh VermaPulmonary DiseaseCA$88.9K984$90.31
Ralph BassettOtolaryngologyAZ$88.4K1.2K$75.88
Joseph ZaladonisDermatologyPA$87.8K1.2K$73.64
Roy MusoffInternal MedicineFL$86.4K1.1K$77.05
Raffi-Jean MesrobianOtolaryngologyCA$82.1K948$86.61
Benjamin TehraniPodiatryCA$81.1K857$94.59
Jonathan HindsGeneral PracticeFL$81.0K1.1K$76.86
Surya ReddyFamily PracticeCA$78.8K983$80.16
David KasperDermatologyPA$76.0K934$81.41
Brandon OconnorFamily PracticeNY$75.4K971$77.66
Leah BushNurse PractitionerAL$75.1K1.1K$68.02
Sohail ShayferOrthopedic SurgeryCA$74.6K824$90.59

🤔 Is New patient office or other outpatient visit, typically 30 minutes Overpriced?

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.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.