CPT 99203 Evaluation & Management
Office o/p new low 30 min Cost
Body System: General
Medicare Facility Rate
$71
CMS PFS CY2026
Medicare Non-Facility Rate
$118
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
1.60
Work RVU
0.38
Facility PE RVU
0.16
Malpractice RVU
3.52
Total RVU
Cost by Location
| Location | Medicare Rate | Est. Commercial |
|---|---|---|
| AK — ALASKA | $97 | $190 — $293 |
| AL — ALABAMA | $68 | $141 — $217 |
| AR — ARKANSAS | $67 | $139 — $214 |
| AZ — ARIZONA | $71 | $150 — $231 |
| CA — BAKERSFIELD | $72 | $160 — $246 |
| CA — CHICO | $71 | $159 — $245 |
| CA — EL CENTRO | $72 | $159 — $245 |
| CA — FRESNO | $71 | $159 — $245 |
| CA — HANFORD-CORCORAN | $71 | $159 — $245 |
| CA — LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) | $75 | $168 — $259 |
| CA — MADERA | $71 | $159 — $245 |
| CA — MERCED | $71 | $159 — $245 |
| CA — MODESTO | $71 | $159 — $245 |
| CA — NAPA | $77 | $179 — $275 |
| CA — OXNARD-THOUSAND OAKS-VENTURA | $74 | $167 — $257 |
| CA — REDDING | $71 | $159 — $245 |
| CA — REST OF CALIFORNIA | $71 | $159 — $245 |
| CA — RIVERSIDE-SAN BERNARDINO-ONTARIO | $73 | $161 — $248 |
| CA — SACRAMENTO-ROSEVILLE-FOLSOM | $73 | $165 — $254 |
| CA — SALINAS | $73 | $165 — $253 |
Frequently Asked Questions
How much does Office o/p new low 30 min cost?
The Medicare facility rate is $71. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Office o/p new low 30 min cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $71.