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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.
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Methodology•Download Data
  1. Home
  2. Procedures
  3. 99212
  4. Cost Analysis

How Much Does Established patient office or other outpatient visit, 10-19 minutes Cost on Medicare?

Cost analysis for CPT 99212 — Established patient office or other outpatient visit, 10-19 minutes

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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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🗺️ State-by-State Cost Variation

The most expensive state pays 1.8x more than the cheapest for this procedure. NY averages $44.36 vs MP at $24.12.

StateAvg PaymentTotal PaymentsServicesProviders
NY$44.36$28.2M635.1K7.9K
DC$43.09$675.0K15.7K240
NJ$42.94$12.3M287.1K3.5K
AK$42.66$690.4K16.2K350
CA$42.17$27.3M646.5K8.0K
CT$40.17$2.9M71.8K1.3K
MD$39.81$6.3M158.4K2.4K
HI$38.75$886.5K22.9K310
FL$38.53$20.4M529.2K6.9K
RI$38.36$819.2K21.4K374
MA$38.21$6.4M166.2K2.7K
DE$37.70$1.5M38.9K476
CO$37.55$3.0M80.3K1.5K
NV$37.38$1.9M51.6K756
IL$37.13$9.6M257.8K4.0K
VA$36.83$6.6M179.0K2.8K
PA$36.48$10.7M293.4K4.7K
AZ$36.17$5.4M149.9K2.3K
MI$36.10$5.4M149.0K2.8K
WY$35.91$831.1K23.1K347
TX$35.87$12.2M340.6K5.5K
WA$35.81$3.2M90.7K1.8K
PR$35.51$298.8K8.4K162
UT$35.34$1.3M36.4K677
GA$34.84$5.7M164.0K2.7K
SC$34.84$4.5M129.0K1.8K
LA$34.57$2.7M77.5K1.2K
MN$34.49$2.0M58.1K1.7K
NH$34.46$1.1M31.5K605
NC$34.42$6.0M174.8K2.9K
OR$34.37$2.2M63.1K1.2K
IN$33.90$4.9M144.2K2.4K
KS$33.74$2.2M65.3K1.0K
VI$33.64$25.3K75314
AL$33.47$2.6M78.2K1.2K
MO$33.36$3.9M117.0K1.9K
KY$33.25$2.9M86.4K1.5K
NM$33.24$1.2M37.1K573
IA$33.16$2.6M77.6K1.2K
NE$33.10$1.5M46.1K804
TN$33.07$4.3M129.9K2.1K
MT$33.02$985.2K29.8K537
OK$33.01$2.5M76.5K1.1K
OH$32.73$7.0M213.2K4.1K
ME$32.58$637.0K19.6K412
SD$32.47$726.3K22.4K437
AR$32.11$2.2M69.4K1.0K
GU$32.09$31.6K98622
MS$31.70$2.3M71.9K959
WI$31.17$2.6M83.9K2.0K
WV$30.28$1.3M41.7K617

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Vladimir SkorokhodEmergency MedicineCA$406.1K7.4K$54.78
Dat NguyenInternal MedicineCA$305.7K5.9K$51.77
Seema ElahiInternal MedicineIL$264.5K6.1K$43.48
Aracely FloresNurse PractitionerCA$165.9K4.6K$36.09
Darius GharibEndocrinologyCA$165.8K3.4K$48.79
Michael ThrasherGeneral PracticeFL$162.6K3.8K$42.26
Victorya MuchnikPodiatryNY$158.9K3.0K$52.11
Frederick KaplanInternal MedicineNY$156.9K3.2K$48.30
John LayOsteopathic Manipulative MedicineCA$139.4K2.9K$47.82
Jose RivasGeneral PracticeFL$131.0K3.0K$43.11
Yoon PakFamily PracticeCA$121.8K2.6K$47.51
Sarah HarvilleNurse PractitionerTX$117.4K3.2K$36.20
Chin KimInternal MedicineCA$108.7K2.3K$48.13
Daniel ShragerDermatologyPA$108.6K2.6K$41.09
Anselmo MendiveFamily PracticeFL$108.2K2.3K$47.57
David TetrokalashviliPodiatryNY$107.6K2.3K$47.02
Lori FinnPodiatryFL$107.0K2.4K$43.96
Eric LewisDermatologyCA$106.3K2.3K$45.77
Tracy MarmerPhysician AssistantNY$106.0K2.4K$44.78
Ashraf HassaneinDermatologyFL$105.7K2.5K$43.12

🤔 Is Established patient office or other outpatient visit, 10-19 minutes Overpriced?

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.

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.