CPT 99202 Evaluation & Management

How Much Does New Patient Office Visit - Straightforward Cost?

Also known as: Office o/p new sf 15 min (CPT 99202)

A first-time visit with a doctor for a single, uncomplicated health issue.

New Patient Office Visit - Straightforward (CPT 99202) costs $41 at Medicare rates.

Medicare (Facility)
$41
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$75
Non-facility setting

Patient Guide: New Patient Office Visit - Straightforward

What you need to know before your appointment

What to Expect

You will fill out health history forms, have vital signs taken, and the doctor will evaluate your concern and create a basic treatment plan.

How Long Does It Take?

15-20 minutes

Common Reasons Doctors Order This

New symptom evaluation, minor infection, skin concern, preventive screening

How to Prepare

Complete any online intake forms beforehand. Bring insurance card, photo ID, and medication list.

Procedures Commonly Done Together

These procedures are frequently performed alongside Office o/p new sf 15 min

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Office o/p new sf 15 min Cost by Location

Medicare-adjusted rates across CMS localities

Location Medicare Rate Est. Commercial
AK — ALASKA $56 $121 — $186
AL — ALABAMA $39 $90 — $139
AR — ARKANSAS $39 $89 — $137
AZ — ARIZONA $41 $96 — $148
CA — BAKERSFIELD $42 $103 — $158
CA — CHICO $41 $103 — $158
CA — EL CENTRO $41 $103 — $158
CA — FRESNO $41 $103 — $158
CA — HANFORD-CORCORAN $41 $103 — $158
CA — LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) $43 $109 — $167
CA — MADERA $41 $103 — $158
CA — MERCED $41 $103 — $158
CA — MODESTO $41 $103 — $158
CA — NAPA $45 $117 — $179
CA — OXNARD-THOUSAND OAKS-VENTURA $43 $108 — $166
CA — REDDING $41 $103 — $158
CA — REST OF CALIFORNIA $41 $103 — $158
CA — RIVERSIDE-SAN BERNARDINO-ONTARIO $42 $104 — $160
CA — SACRAMENTO-ROSEVILLE-FOLSOM $43 $107 — $165
CA — SALINAS $42 $107 — $164
CA — SAN DIEGO-CHULA VISTA-CARLSBAD $43 $109 — $167
CA — SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) $46 $123 — $189
CA — SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) $46 $123 — $189
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) $47 $125 — $193
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) $47 $125 — $192

How to Reduce Your Cost for Office o/p new sf 15 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 ($75) differs from the facility rate ($41). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Medicare rates for this procedure range from $39 to $56 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.

0.93
Work RVU
0.23
Practice Expense RVU
0.07
Malpractice RVU
2.25
Total RVU

Payment = Total RVU (2.25) x CF ($33.40) = $75

Frequently Asked Questions

How much does Office o/p new sf 15 min cost?

The Medicare facility rate for Office o/p new sf 15 min is $41. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Office o/p new sf 15 min cost without insurance?

Without insurance, the cost of Office o/p new sf 15 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 sf 15 min?

Most commercial health insurance plans and Medicare cover Office o/p new sf 15 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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