Cost analysis for CPT 99205 — New patient office or other outpatient visit, 60-74 minutes
Average Medicare Payment
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Total Payments (Latest)
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Services (Latest)
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Price Change (–)
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The most expensive state pays 1.5x more than the cheapest for this procedure. AK averages $195.78 vs ID at $129.75.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $195.78 | $1.0M | 5.1K | 136 |
| NY | $175.37 | $27.1M | 154.5K | 4.3K |
| NJ | $171.97 | $12.8M | 74.3K | 2.0K |
| DC | $168.84 | $1.9M | 11.0K | 332 |
| CA | $167.78 | $60.3M | 359.1K | 8.4K |
| MD | $163.94 | $12.4M | 75.7K | 1.9K |
| CT | $159.78 | $3.7M | 23.1K | 799 |
| FL | $158.01 | $31.8M | 201.5K | 4.8K |
| IL | $157.92 | $15.7M | 99.4K | 2.7K |
| MA | $156.58 | $13.4M | 85.3K | 2.4K |
| HI | $155.75 | $1.0M | 6.6K | 202 |
| NV | $154.64 | $3.1M | 20.2K | 450 |
| RI | $153.64 | $838.3K | 5.5K | 201 |
| VA | $152.71 | $9.3M | 60.9K | 1.6K |
| PA | $151.91 | $15.1M | 99.5K | 3.1K |
| WA | $151.72 | $9.8M | 64.5K | 1.8K |
| PR | $151.68 | $111.9K | 738 | 32 |
| DE | $151.51 | $1.5M | 9.9K | 234 |
| TX | $151.11 | $23.8M | 157.7K | 4.3K |
| GA | $151.01 | $8.4M | 55.9K | 1.6K |
| AZ | $150.81 | $11.4M | 75.6K | 1.7K |
| CO | $150.75 | $6.5M | 43.2K | 1.3K |
| WY | $149.99 | $533.4K | 3.6K | 84 |
| MN | $149.95 | $5.5M | 37.0K | 1.4K |
| GU | $149.47 | $38.1K | 255 | 7 |
| OR | $148.50 | $4.4M | 29.4K | 937 |
| SC | $147.36 | $5.8M | 39.4K | 1.0K |
| MI | $146.98 | $7.2M | 49.1K | 1.7K |
| LA | $145.34 | $4.0M | 27.4K | 768 |
| MO | $144.89 | $4.8M | 32.8K | 1.0K |
| NH | $143.63 | $2.2M | 15.0K | 443 |
| AL | $142.88 | $4.1M | 28.4K | 817 |
| IN | $142.79 | $6.0M | 41.9K | 1.2K |
| NC | $142.58 | $11.1M | 78.1K | 2.3K |
| UT | $142.45 | $1.9M | 13.1K | 461 |
| OK | $142.26 | $3.6M | 25.5K | 621 |
| KY | $142.22 | $2.6M | 18.4K | 590 |
| OH | $141.97 | $9.0M | 63.7K | 2.1K |
| TN | $141.77 | $6.3M | 44.7K | 1.3K |
| NM | $141.46 | $1.5M | 10.5K | 343 |
| MS | $139.63 | $2.6M | 18.8K | 428 |
| KS | $139.18 | $3.3M | 24.0K | 555 |
| AR | $138.74 | $2.5M | 17.9K | 449 |
| MT | $138.51 | $1.6M | 11.3K | 301 |
| NE | $138.50 | $1.9M | 13.8K | 384 |
| WV | $138.18 | $874.6K | 6.3K | 208 |
| VI | $137.56 | $79.0K | 574 | 16 |
| WI | $136.65 | $4.3M | 31.4K | 1.1K |
| IA | $136.10 | $2.0M | 14.7K | 476 |
| ME | $136.07 | $1.0M | 7.6K | 259 |
| ND | $134.98 | $823.4K | 6.1K | 160 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Scott Martin | Physical Medicine and Rehabilitation | NV | $185.1K | 1.1K | $165.08 |
| Ian Purcell | Neurology | CA | $146.4K | 831 | $176.23 |
| Adam Luckette | Physician Assistant | NV | $113.1K | 785 | $144.02 |
| Patricio Espinosa | Neurology | FL | $103.7K | 595 | $174.21 |
| Shahryar Yadegar | Pulmonary Disease | CA | $102.0K | 576 | $177.10 |
| Charles Dow | Cardiology | MA | $101.1K | 582 | $173.74 |
| Nicola Azar | Family Practice | CA | $93.6K | 534 | $175.23 |
| Moeen Din | Neurology | AZ | $91.8K | 598 | $153.50 |
| Benjamin Memmott | General Practice | TX | $89.8K | 533 | $168.54 |
| Douglas Vogt | Internal Medicine | MO | $86.0K | 598 | $143.75 |
| Stuart Hetrick | Neurology | AZ | $85.3K | 578 | $147.54 |
| David Silvers | Neurology | FL | $84.1K | 487 | $172.67 |
| Fernando Enrile | General Practice | CA | $80.6K | 434 | $185.83 |
| Paul Nguyen | Urology | AZ | $73.5K | 451 | $163.00 |
| Francis Hussey | Interventional Pain Management | FL | $72.8K | 422 | $172.42 |
| Kennedy Yalamanchili | Neurosurgery | DE | $72.3K | 436 | $165.82 |
| Linda Ruiz | Nurse Practitioner | NV | $71.5K | 496 | $144.09 |
| Luke Liu | Anesthesiology | AK | $71.4K | 323 | $221.00 |
| Jack Flyer | Cardiology | MD | $68.9K | 369 | $186.70 |
| Edward Jaoude | Ophthalmology | DE | $64.8K | 419 | $154.62 |
Based on the data, CPT 99205 shows a 1.5x variation in pricing across states — moderate variation by Medicare standards.
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.