Cost analysis for CPT 99214 — Established patient office or other outpatient, visit typically 25 minutes
Average Medicare Payment
$79.93
2023 data
Total Payments (2023)
$8.2B
Services (2023)
99.3M
Price Change (2014–2023)
+14.1%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $70.06 | $6.5B | 90.6M | — |
| 2015 | $70.06 | $6.8B | 94.7M | 0.0% |
| 2016 | $68.38 | $7.0B | 99.0M | -2.4% |
| 2017 | $67.73 | $7.1B | 101.1M | -1.0% |
| 2018 | $67.86 | $7.2B | 103.1M | +0.2% |
| 2019 | $69.21 | $7.6B | 105.7M | +2.0% |
| 2020 | $67.81 | $6.2B | 87.6M | -2.0% |
| 2021 | $84.62 | $8.4B | 96.3M | +24.8% |
| 2022 | $81.20 | $8.1B | 97.2M | -4.0% |
| 2023 | $79.93 | $8.2B | 99.3M | -1.6% |
The most expensive state pays 1.7x more than the cheapest for this procedure. AK averages $102.33 vs MP at $59.04.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $102.33 | $19.6M | 191.1K | 1.2K |
| NY | $96.86 | $577.5M | 6.0M | 30.4K |
| DC | $95.60 | $21.5M | 224.9K | 1.4K |
| NJ | $93.90 | $321.6M | 3.4M | 13.6K |
| CA | $93.68 | $880.4M | 9.4M | 38.0K |
| CT | $90.27 | $91.8M | 1.0M | 6.5K |
| XX | $87.93 | $205.7K | 2.3K | 13 |
| FL | $86.88 | $819.2M | 9.4M | 32.8K |
| AE | $86.80 | $293.3K | 3.4K | 19 |
| GU | $86.52 | $2.4M | 27.3K | 92 |
| MD | $85.21 | $247.5M | 2.9M | 10.3K |
| IL | $84.74 | $316.9M | 3.7M | 18.5K |
| MA | $84.70 | $240.9M | 2.8M | 15.4K |
| NV | $84.03 | $68.6M | 816.0K | 3.6K |
| DE | $83.66 | $46.5M | 555.4K | 1.8K |
| AZ | $83.08 | $214.3M | 2.6M | 10.4K |
| PR | $82.74 | $3.1M | 37.7K | 474 |
| VA | $82.68 | $270.2M | 3.3M | 12.9K |
| TX | $82.38 | $571.7M | 6.9M | 32.5K |
| WA | $81.92 | $147.3M | 1.8M | 10.9K |
| GA | $81.55 | $242.7M | 3.0M | 13.6K |
| PA | $80.76 | $337.7M | 4.2M | 23.2K |
| HI | $80.22 | $21.9M | 273.1K | 1.4K |
| WY | $80.15 | $11.6M | 144.7K | 784 |
| SC | $79.82 | $182.6M | 2.3M | 7.9K |
| RI | $79.19 | $22.8M | 288.0K | 1.9K |
| CO | $78.84 | $92.0M | 1.2M | 8.2K |
| LA | $78.07 | $109.7M | 1.4M | 6.7K |
| UT | $77.88 | $47.3M | 606.9K | 4.1K |
| ZZ | $77.64 | $123.8K | 1.6K | 20 |
| NC | $77.62 | $273.0M | 3.5M | 18.1K |
| MN | $77.44 | $81.3M | 1.0M | 10.1K |
| AL | $77.17 | $123.3M | 1.6M | 7.3K |
| VI | $77.00 | $1.2M | 15.3K | 76 |
| AP | $76.90 | $137.1K | 1.8K | 15 |
| MI | $76.90 | $177.1M | 2.3M | 15.5K |
| IN | $76.85 | $163.4M | 2.1M | 10.5K |
| NH | $76.14 | $41.7M | 547.1K | 3.1K |
| TN | $75.73 | $188.3M | 2.5M | 11.4K |
| MO | $75.69 | $124.1M | 1.6M | 9.0K |
| NM | $75.03 | $34.8M | 463.8K | 2.7K |
| KY | $74.39 | $101.7M | 1.4M | 7.2K |
| OR | $74.34 | $62.7M | 844.1K | 6.1K |
| KS | $73.82 | $70.9M | 961.1K | 4.3K |
| WI | $73.77 | $90.6M | 1.2M | 9.8K |
| MS | $73.76 | $90.0M | 1.2M | 4.1K |
| OK | $73.40 | $102.4M | 1.4M | 5.6K |
| IA | $73.24 | $67.7M | 925.0K | 4.7K |
| NE | $72.74 | $47.9M | 658.2K | 3.2K |
| OH | $72.37 | $234.1M | 3.2M | 20.0K |
| WV | $71.74 | $32.4M | 451.8K | 2.7K |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Salar Deldar | Pain Management | CA | $846.6K | 10.6K | $79.88 |
| Artur Henke | Dermatology | CA | $824.9K | 7.8K | $106.30 |
| Andrew Donato | Emergency Medicine | SC | $768.9K | 8.2K | $94.29 |
| Jiho Choi | Family Practice | VA | $657.8K | 5.9K | $110.74 |
| Timothy Groth | Interventional Pain Management | NY | $640.1K | 5.6K | $113.49 |
| Youram Nassir | Hematology | CA | $625.3K | 5.7K | $109.46 |
| Pete Coury | Family Practice | AZ | $591.2K | 6.9K | $85.34 |
| Stephen Luther | Internal Medicine | SC | $575.1K | 6.6K | $86.68 |
| Evelyn Li | Cardiology | CA | $573.8K | 4.7K | $121.79 |
| Vernon Bowman | Family Practice | AR | $558.2K | 7.6K | $73.14 |
| Diana Gorokhovsky | Family Practice | FL | $557.0K | 5.9K | $95.11 |
| Mohsen El Ramah | Internal Medicine | CA | $551.8K | 5.7K | $97.65 |
| Lan Luo | Cardiology | FL | $541.8K | 5.9K | $91.78 |
| Uri Ben-Zur | Cardiology | CA | $540.5K | 4.9K | $109.55 |
| Fadi Atassi | Cardiology | AZ | $539.1K | 6.0K | $89.78 |
| Jason Karp | Pulmonary Disease | NY | $520.1K | 4.5K | $116.02 |
| Robert Salazar | Interventional Pain Management | CA | $519.4K | 5.3K | $97.37 |
| James Lin | Anesthesiology | CA | $516.1K | 4.9K | $105.94 |
| Thomas Coury | Pain Management | AZ | $514.0K | 5.7K | $90.00 |
| Florian Gegaj | Internal Medicine | FL | $513.5K | 5.5K | $92.65 |
Based on the data, CPT 99214 shows a 1.7x variation in pricing across states — moderate variation by Medicare standards.
Costs have increased 14.1% 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.