CPT 99204 Evaluation & Management

How Much Does New Patient Office Visit - Moderate Complexity Cost?

Also known as: Office o/p new mod 45 min (CPT 99204)

A comprehensive first-time visit for a problem that requires thorough evaluation and possibly multiple treatment options.

New Patient Office Visit - Moderate Complexity (CPT 99204) costs $117 at Medicare rates.

Medicare (Facility)
$117
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$177
Non-facility setting

Patient Guide: New Patient Office Visit - Moderate Complexity

What you need to know before your appointment

What to Expect

Expect a detailed health history review, thorough physical exam, and discussion of test results or treatment plans. The doctor may order labs or imaging.

How Long Does It Take?

30-45 minutes

Common Reasons Doctors Order This

Chronic pain evaluation, new diagnosis workup, multiple health concerns, pre-surgical consultation

How to Prepare

Bring all medical records, test results, and imaging from other providers. Prepare a list of questions.

Procedures Commonly Done Together

These procedures are frequently performed alongside Office o/p new mod 45 min

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Office o/p new mod 45 min Cost by Location

Medicare-adjusted rates across CMS localities

Location Medicare Rate Est. Commercial
AK — ALASKA $159 $291 — $447
AZ — ARIZONA $116 $227 — $349
CA — BAKERSFIELD $118 $240 — $369
CA — CHICO $117 $239 — $368
CA — EL CENTRO $117 $239 — $368
CA — FRESNO $117 $239 — $368
CA — HANFORD-CORCORAN $117 $239 — $368
CA — LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) $122 $253 — $389
CA — MADERA $117 $239 — $368
CA — MERCED $117 $239 — $368
CA — MODESTO $117 $239 — $368
CA — NAPA $126 $268 — $412
CA — OXNARD-THOUSAND OAKS-VENTURA $121 $251 — $385
CA — REDDING $117 $239 — $368
CA — REST OF CALIFORNIA $117 $239 — $368
CA — RIVERSIDE-SAN BERNARDINO-ONTARIO $120 $243 — $373
CA — SACRAMENTO-ROSEVILLE-FOLSOM $121 $249 — $382
CA — SALINAS $120 $248 — $381
CA — SAN DIEGO-CHULA VISTA-CARLSBAD $121 $251 — $387
CA — SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) $131 $281 — $432
CA — SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) $130 $281 — $432
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) $133 $287 — $442
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) $132 $286 — $439
CA — SAN LUIS OBISPO-PASO ROBLES $118 $244 — $375
CA — SANTA CRUZ-WATSONVILLE $120 $252 — $388

What Insurance Companies Actually Pay

Real negotiated rates from 7 hospitals across 5 states (from hospital price transparency filings)

Lowest
$22
Highest
$1,176
Average
$268
Insurance Company Avg Rate Range Hospitals
Aetna $357 $43 - $620 5
BCBS-TX $314 $192 - $417 2
United $138 $30 - $320 3
Cigna $173 $92 - $477 4
CHC $236 $45 - $375 2
Kaiser $38 $29 - $51 1
Multiplan $228 $100 - $395 2
Humana $293 $101 - $443 2
Peach State $258 $115 - $497 2
BCBS - Anthem $258 $105 - $356 1
OPTUM $331 $184 - $563 1
Employers Health Network $95 $95 2
Average by State
CO: $125 (33) KY: $222 (16) TN: $269 (8) TX: $348 (54) GA: $353 (13)
Disclaimer: These rates are from hospital Machine-Readable Files (MRFs) required by federal price transparency law. They reflect specific hospital-payer contracts and may not represent your actual cost, which depends on your plan, deductible, and network status. Data sourced from CommonSpirit Health, HCA Healthcare, and Kaiser Permanente filings.

How to Reduce Your Cost for Office o/p new mod 45 min

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($177) differs from the facility rate ($117). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Medicare rates for this procedure range from $111 to $159 depending on location. Commercial rates vary even more.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

2.60
Work RVU
0.66
Practice Expense RVU
0.24
Malpractice RVU
5.31
Total RVU

Payment = Total RVU (5.31) x CF ($33.40) = $177

Consider These Alternatives

Depending on your clinical situation, these alternatives may be appropriate and could save you money.

Note: Alternative procedures may not be clinically appropriate for all patients. Always consult your physician to determine the best option for your specific situation.

Frequently Asked Questions

How much does Office o/p new mod 45 min cost?

The Medicare facility rate for Office o/p new mod 45 min is $117. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Office o/p new mod 45 min cost without insurance?

Without insurance, the cost of Office o/p new mod 45 min can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Office o/p new mod 45 min?

Most commercial health insurance plans and Medicare cover Office o/p new mod 45 min when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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