Cost analysis for CPT 99212 — Established patient office or other outpatient visit, 10-19 minutes
Average Medicare Payment
N/A
Total Payments (Latest)
N/A
Services (Latest)
N/A
Price Change (–)
N/A
The most expensive state pays 1.8x more than the cheapest for this procedure. NY averages $44.36 vs MP at $24.12.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| NY | $44.36 | $28.2M | 635.1K | 7.9K |
| DC | $43.09 | $675.0K | 15.7K | 240 |
| NJ | $42.94 | $12.3M | 287.1K | 3.5K |
| AK | $42.66 | $690.4K | 16.2K | 350 |
| CA | $42.17 | $27.3M | 646.5K | 8.0K |
| CT | $40.17 | $2.9M | 71.8K | 1.3K |
| MD | $39.81 | $6.3M | 158.4K | 2.4K |
| HI | $38.75 | $886.5K | 22.9K | 310 |
| FL | $38.53 | $20.4M | 529.2K | 6.9K |
| RI | $38.36 | $819.2K | 21.4K | 374 |
| MA | $38.21 | $6.4M | 166.2K | 2.7K |
| DE | $37.70 | $1.5M | 38.9K | 476 |
| CO | $37.55 | $3.0M | 80.3K | 1.5K |
| NV | $37.38 | $1.9M | 51.6K | 756 |
| IL | $37.13 | $9.6M | 257.8K | 4.0K |
| VA | $36.83 | $6.6M | 179.0K | 2.8K |
| PA | $36.48 | $10.7M | 293.4K | 4.7K |
| AZ | $36.17 | $5.4M | 149.9K | 2.3K |
| MI | $36.10 | $5.4M | 149.0K | 2.8K |
| WY | $35.91 | $831.1K | 23.1K | 347 |
| TX | $35.87 | $12.2M | 340.6K | 5.5K |
| WA | $35.81 | $3.2M | 90.7K | 1.8K |
| PR | $35.51 | $298.8K | 8.4K | 162 |
| UT | $35.34 | $1.3M | 36.4K | 677 |
| GA | $34.84 | $5.7M | 164.0K | 2.7K |
| SC | $34.84 | $4.5M | 129.0K | 1.8K |
| LA | $34.57 | $2.7M | 77.5K | 1.2K |
| MN | $34.49 | $2.0M | 58.1K | 1.7K |
| NH | $34.46 | $1.1M | 31.5K | 605 |
| NC | $34.42 | $6.0M | 174.8K | 2.9K |
| OR | $34.37 | $2.2M | 63.1K | 1.2K |
| IN | $33.90 | $4.9M | 144.2K | 2.4K |
| KS | $33.74 | $2.2M | 65.3K | 1.0K |
| VI | $33.64 | $25.3K | 753 | 14 |
| AL | $33.47 | $2.6M | 78.2K | 1.2K |
| MO | $33.36 | $3.9M | 117.0K | 1.9K |
| KY | $33.25 | $2.9M | 86.4K | 1.5K |
| NM | $33.24 | $1.2M | 37.1K | 573 |
| IA | $33.16 | $2.6M | 77.6K | 1.2K |
| NE | $33.10 | $1.5M | 46.1K | 804 |
| TN | $33.07 | $4.3M | 129.9K | 2.1K |
| MT | $33.02 | $985.2K | 29.8K | 537 |
| OK | $33.01 | $2.5M | 76.5K | 1.1K |
| OH | $32.73 | $7.0M | 213.2K | 4.1K |
| ME | $32.58 | $637.0K | 19.6K | 412 |
| SD | $32.47 | $726.3K | 22.4K | 437 |
| AR | $32.11 | $2.2M | 69.4K | 1.0K |
| GU | $32.09 | $31.6K | 986 | 22 |
| MS | $31.70 | $2.3M | 71.9K | 959 |
| WI | $31.17 | $2.6M | 83.9K | 2.0K |
| WV | $30.28 | $1.3M | 41.7K | 617 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Vladimir Skorokhod | Emergency Medicine | CA | $406.1K | 7.4K | $54.78 |
| Dat Nguyen | Internal Medicine | CA | $305.7K | 5.9K | $51.77 |
| Seema Elahi | Internal Medicine | IL | $264.5K | 6.1K | $43.48 |
| Aracely Flores | Nurse Practitioner | CA | $165.9K | 4.6K | $36.09 |
| Darius Gharib | Endocrinology | CA | $165.8K | 3.4K | $48.79 |
| Michael Thrasher | General Practice | FL | $162.6K | 3.8K | $42.26 |
| Victorya Muchnik | Podiatry | NY | $158.9K | 3.0K | $52.11 |
| Frederick Kaplan | Internal Medicine | NY | $156.9K | 3.2K | $48.30 |
| John Lay | Osteopathic Manipulative Medicine | CA | $139.4K | 2.9K | $47.82 |
| Jose Rivas | General Practice | FL | $131.0K | 3.0K | $43.11 |
| Yoon Pak | Family Practice | CA | $121.8K | 2.6K | $47.51 |
| Sarah Harville | Nurse Practitioner | TX | $117.4K | 3.2K | $36.20 |
| Chin Kim | Internal Medicine | CA | $108.7K | 2.3K | $48.13 |
| Daniel Shrager | Dermatology | PA | $108.6K | 2.6K | $41.09 |
| Anselmo Mendive | Family Practice | FL | $108.2K | 2.3K | $47.57 |
| David Tetrokalashvili | Podiatry | NY | $107.6K | 2.3K | $47.02 |
| Lori Finn | Podiatry | FL | $107.0K | 2.4K | $43.96 |
| Eric Lewis | Dermatology | CA | $106.3K | 2.3K | $45.77 |
| Tracy Marmer | Physician Assistant | NY | $106.0K | 2.4K | $44.78 |
| Ashraf Hassanein | Dermatology | FL | $105.7K | 2.5K | $43.12 |
Based on the data, CPT 99212 shows a 1.8x 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.