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Procedure price report · Consultation, evaluation, and preventative care

Office visit for a new patient, moderate complexity

CPT 99204the billing code this page is about

An outpatient office or clinic visit for a patient new to the practice, at a moderate level of medical decision making or about 45 to 59 minutes of the clinician's time.

Hospitals typically charge $208 cash for this outpatient procedure — the median across 2,580 hospitals that filed a usable cash price; the average of the middle 60% is $221. Most fall between $111 and $383 (20th–80th percentile).

Hospitals
2,580
States
50
Filings dated
Aug 2022 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 24, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 2,580 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$76$126$208$338$534

The most expensive tenth of hospitals charges at least 7.1× what the cheapest tenth charges ($76 vs $534).

How the prices are spread

$55 – $72: 107 hospitals$55$72 – $95: 160 hospitals$95 – $124: 239 hospitals$95$124 – $163: 327 hospitals$163 – $214: 355 hospitals$163$214 – $281: 357 hospitals$281 – $369: 354 hospitals$281$369 – $485: 244 hospitals$485 – $636: 107 hospitals$485$636 – $835: 74 hospitals$636median $208price bands are equal on a log scale
Hospitals per price band (2,324 of 2,580 — the bands cover the 5th to 95th percentile)
FromToHospitals
$55$72107
$72$95160
$95$124239
$124$163327
$163$214355
$214$281357
$281$369354
$369$485244
$485$636107
$636$83574

By state

The median cash price in each state, against the national median of $208.

Alaska: median $379 across 16 hospitalsAK$379Maine: median $131 across 24 hospitalsME$131Vermont: median $219 across 13 hospitalsVT$219New Hampshire: median $163 across 23 hospitalsNH$163Washington: median $228 across 52 hospitalsWA$228Idaho: median $251 across 16 hospitalsID$251Montana: median $194 across 24 hospitalsMT$194North Dakota: median $375 across 24 hospitalsND$375Minnesota: median $183 across 88 hospitalsMN$183Illinois: median $235 across 116 hospitalsIL$235Wisconsin: median $230 across 89 hospitalsWI$230Michigan: median $118 across 64 hospitalsMI$118New York: median $255 across 102 hospitalsNY$255Massachusetts: median $352 across 47 hospitalsMA$352Oregon: median $248 across 48 hospitalsOR$248Nevada: median $278 across 18 hospitalsNV$278Wyoming: median $250 across 13 hospitalsWY$250South Dakota: median $232 across 33 hospitalsSD$232Iowa: median $230 across 93 hospitalsIA$230Indiana: median $113 across 70 hospitalsIN$113Ohio: median $145 across 77 hospitalsOH$145Pennsylvania: median $255 across 97 hospitalsPA$255New Jersey: median $158 across 35 hospitalsNJ$158Connecticut: median $330 across 23 hospitalsCT$330Rhode Island: 8 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $245 across 111 hospitalsCA$245Utah: median $251 across 36 hospitalsUT$251Colorado: median $281 across 45 hospitalsCO$281Nebraska: median $263 across 77 hospitalsNE$263Missouri: median $177 across 64 hospitalsMO$177Kentucky: median $176 across 49 hospitalsKY$176West Virginia: median $122 across 36 hospitalsWV$122Virginia: median $158 across 46 hospitalsVA$158Maryland: median $239 across 37 hospitalsMD$239Delaware: 6 hospitals filed a usable price — fewer than 10, so no figureDEArizona: median $235 across 41 hospitalsAZ$235New Mexico: median $269 across 13 hospitalsNM$269Kansas: median $162 across 78 hospitalsKS$162Arkansas: median $149 across 28 hospitalsAR$149Tennessee: median $90 across 57 hospitalsTN$90North Carolina: median $236 across 51 hospitalsNC$236South Carolina: median $189 across 51 hospitalsSC$189Oklahoma: median $127 across 53 hospitalsOK$127Louisiana: median $99 across 41 hospitalsLA$99Mississippi: median $117 across 43 hospitalsMS$117Alabama: median $171 across 31 hospitalsAL$171Georgia: median $200 across 91 hospitalsGA$200Hawaii: median $239 across 13 hospitalsHI$239Texas: median $265 across 151 hospitalsTX$265Florida: median $562 across 118 hospitalsFL$562
Cash price by state, most expensive first. National median $208. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Florida FL118$562+170%$178 – $1,227
Alaska AK16$379+82%$282 – $540
North Dakota ND24$375+80%$156 – $469
Massachusetts MA47$352+69%$191 – $460
Connecticut CT23$330+58%$230 – $419
Colorado CO45$281+35%$162 – $530
Nevada NV18$278+34%$161 – $729
New Mexico NM13$269+29%$160 – $381
Texas TX151$265+27%$119 – $441
Nebraska NE77$263+26%$142 – $324
New York NY102$255+22%$128 – $454
Pennsylvania PA97$255+22%$126 – $389
Idaho ID16$251+20%$133 – $313
Utah UT36$251+20%$222 – $378
Wyoming WY13$250+20%$135 – $336
Oregon OR48$248+19%$128 – $383
California CA111$245+18%$125 – $390
Maryland MD37$239+15%$152 – $316
Hawaii HI13$239+15%$101 – $375
North Carolina NC51$236+13%$118 – $358
Arizona AZ41$235+13%$132 – $386
Illinois IL116$235+13%$145 – $437
South Dakota SD33$232+11%$154 – $430
Iowa IA93$230+11%$120 – $291
Wisconsin WI89$230+10%$148 – $351
Washington WA52$228+9%$136 – $326
Vermont VT13$219+5%$111 – $299
Georgia GA91$200−4%$149 – $407
Montana MT24$194−7%$88 – $400
South Carolina SC51$189−9%$102 – $495
Minnesota MN88$183−12%$104 – $283
Missouri MO64$177−15%$105 – $274
Kentucky KY49$176−16%$109 – $296
Alabama AL31$171−18%$88 – $434
New Hampshire NH23$163−22%$55 – $498
Kansas KS78$162−22%$80 – $245
New Jersey NJ35$158−24%$131 – $582
Virginia VA46$158−24%$138 – $388
Arkansas AR28$149−29%$94 – $224
Ohio OH77$145−31%$113 – $309
Maine ME24$131−37%$59 – $346
Oklahoma OK53$127−39%$81 – $239
West Virginia WV36$122−41%$65 – $234
Michigan MI64$118−43%$96 – $236
Mississippi MS43$117−44%$69 – $192
Indiana IN70$113−46%$67 – $252
Louisiana LA41$99−52%$57 – $204
Tennessee TN57$90−57%$51 – $331
Rhode Island RI8not enough hospitals filed a usable price
Delaware DE6not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $208.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care1,687$219$115 – $417
Children’s55$321$140 – $460
Critical access833$188$96 – $315
Ownership
For-profit289$368$148 – $948
Government545$182$98 – $303
Non-profit1,741$207$111 – $369
System affiliation
Part of a system2,038$212$113 – $393
Independent542$196$100 – $335

Cash price vs list price

Median list price (chargemaster)$344
Median cash price$208
Cash as a share of list, median hospital68%

At the typical hospital, asking for the cash price cuts the list price by about 32%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

1,604 hospitals filed a usable inpatient cash price for this code. The median is $219 and the average of the middle 60% is $225; most fall between $116 and $370.

Cash price percentiles, inpatient, across 1,604 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$80$129$219$332$503

The most expensive tenth of hospitals charges at least 6.3× what the cheapest tenth charges ($80 vs $503).

Of the 1,724 hospitals that filed this code inpatient, 1,604 gave a usable cash price; 21 carried a plausibility flag, 2 filed a number their own filing marks as not a price, 0 gave an estimate, and 97 a list price only.

How complete is this

2,580 of the 3,956 hospitals with a price file in our corpus (65%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 2,787 hospitals that filed this code at all gave us
Usable cash price — counted2,580
Cash price carrying a plausibility flag — shown on the compare tool, excluded here44
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded2
An estimate rather than a filed cash price — excluded0
A list price only, no cash figure — excluded161
Hospitals that filed this code2,787

Sections not shown for this setting

  • Against Medicare: Medicare has no separately payable national outpatient (OPPS) rate for this code, so there is nothing honest to compare against.
  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between July 20, 2026 and September 24, 2026; the figures were computed September 25, 2026 from filings loaded through September 24, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Consultation, evaluation, and preventative care family.

Hospitals file this code under descriptions such as Office/Outpatient New Moderate Mdm 45 Minutes.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “Office visit for a new patient, moderate complexity (CPT 99204) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-99204-office-visit-for-a-new-patient-moderate-complexity