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Procedure price report · Consultation, evaluation, and preventative care

Office visit for a new patient, high complexity (level 5)

CPT 99205the billing code this page is about

An outpatient or office visit for a patient new to the practice involving a problem of high complexity, typically 60 to 74 minutes of the clinician's time.

Hospitals typically charge $262 cash for this outpatient procedure — the median across 2,522 hospitals that filed a usable cash price; the average of the middle 60% is $279. Most fall between $138 and $493 (20th–80th percentile).

Hospitals
2,522
States
50
Filings dated
Aug 2022 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 25, 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 2,522 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
$95$154$262$434$688

The most expensive tenth of hospitals charges at least 7.2× what the cheapest tenth charges ($95 vs $688).

How the prices are spread

$69 – $91: 95 hospitals$69$91 – $119: 175 hospitals$119 – $157: 243 hospitals$119$157 – $207: 269 hospitals$207 – $272: 378 hospitals$207$272 – $358: 383 hospitals$358 – $471: 306 hospitals$358$471 – $619: 236 hospitals$619 – $815: 121 hospitals$619$815 – $1,072: 64 hospitals$815median $262price bands are equal on a log scale
Hospitals per price band (2,270 of 2,522 — the bands cover the 5th to 95th percentile)
FromToHospitals
$69$9195
$91$119175
$119$157243
$157$207269
$207$272378
$272$358383
$358$471306
$471$619236
$619$815121
$815$1,07264

By state

The median cash price in each state, against the national median of $262.

Alaska: median $525 across 17 hospitalsAK$525Maine: median $196 across 25 hospitalsME$196Vermont: median $287 across 13 hospitalsVT$287New Hampshire: median $207 across 21 hospitalsNH$207Washington: median $300 across 51 hospitalsWA$300Idaho: median $275 across 14 hospitalsID$275Montana: median $251 across 24 hospitalsMT$251North Dakota: median $482 across 22 hospitalsND$482Minnesota: median $242 across 86 hospitalsMN$242Illinois: median $307 across 111 hospitalsIL$307Wisconsin: median $305 across 87 hospitalsWI$305Michigan: median $147 across 63 hospitalsMI$147New York: median $324 across 103 hospitalsNY$324Massachusetts: median $423 across 48 hospitalsMA$423Oregon: median $330 across 47 hospitalsOR$330Nevada: median $331 across 18 hospitalsNV$331Wyoming: median $300 across 13 hospitalsWY$300South Dakota: median $279 across 28 hospitalsSD$279Iowa: median $308 across 89 hospitalsIA$308Indiana: median $158 across 69 hospitalsIN$158Ohio: median $191 across 76 hospitalsOH$191Pennsylvania: median $283 across 94 hospitalsPA$283New Jersey: median $215 across 35 hospitalsNJ$215Connecticut: median $445 across 22 hospitalsCT$445Rhode Island: 8 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $287 across 104 hospitalsCA$287Utah: median $251 across 34 hospitalsUT$251Colorado: median $341 across 42 hospitalsCO$341Nebraska: median $328 across 72 hospitalsNE$328Missouri: median $241 across 64 hospitalsMO$241Kentucky: median $218 across 48 hospitalsKY$218West Virginia: median $152 across 30 hospitalsWV$152Virginia: median $205 across 47 hospitalsVA$205Maryland: median $286 across 36 hospitalsMD$286Delaware: 6 hospitals filed a usable price — fewer than 10, so no figureDEArizona: median $289 across 42 hospitalsAZ$289New Mexico: median $303 across 13 hospitalsNM$303Kansas: median $212 across 78 hospitalsKS$212Arkansas: median $154 across 29 hospitalsAR$154Tennessee: median $128 across 58 hospitalsTN$128North Carolina: median $295 across 53 hospitalsNC$295South Carolina: median $252 across 51 hospitalsSC$252Oklahoma: median $163 across 54 hospitalsOK$163Louisiana: median $122 across 39 hospitalsLA$122Mississippi: median $153 across 44 hospitalsMS$153Alabama: median $324 across 28 hospitalsAL$324Georgia: median $240 across 89 hospitalsGA$240Hawaii: median $267 across 13 hospitalsHI$267Texas: median $293 across 150 hospitalsTX$293Florida: median $618 across 114 hospitalsFL$618
Cash price by state, most expensive first. National median $262. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Florida FL114$618+135%$225 – $1,380
Alaska AK17$525+100%$266 – $728
North Dakota ND22$482+84%$203 – $624
Connecticut CT22$445+70%$303 – $478
Massachusetts MA48$423+61%$226 – $616
Colorado CO42$341+30%$220 – $589
Nevada NV18$331+26%$238 – $988
Oregon OR47$330+26%$174 – $521
Nebraska NE72$328+25%$196 – $429
New York NY103$324+24%$174 – $543
Alabama AL28$324+24%$125 – $697
Iowa IA89$308+17%$169 – $388
Illinois IL111$307+17%$166 – $564
Wisconsin WI87$305+16%$194 – $459
New Mexico NM13$303+16%$169 – $519
Wyoming WY13$300+14%$162 – $422
Washington WA51$300+14%$181 – $400
North Carolina NC53$295+13%$152 – $379
Texas TX150$293+12%$112 – $574
Arizona AZ42$289+10%$161 – $729
California CA104$287+9%$154 – $584
Vermont VT13$287+9%$150 – $427
Maryland MD36$286+9%$182 – $388
Pennsylvania PA94$283+8%$132 – $586
South Dakota SD28$279+6%$190 – $570
Idaho ID14$275+5%$127 – $401
Hawaii HI13$267+2%$145 – $418
South Carolina SC51$252−4%$129 – $709
Montana MT24$251−4%$109 – $488
Utah UT34$251−4%$251 – $668
Minnesota MN86$242−8%$116 – $503
Missouri MO64$241−8%$138 – $349
Georgia GA89$240−8%$176 – $656
Kentucky KY48$218−17%$140 – $357
New Jersey NJ35$215−18%$161 – $612
Kansas KS78$212−19%$120 – $320
New Hampshire NH21$207−21%$65 – $651
Virginia VA47$205−22%$66 – $402
Maine ME25$196−25%$72 – $374
Ohio OH76$191−27%$129 – $388
Oklahoma OK54$163−38%$95 – $298
Indiana IN69$158−40%$84 – $319
Arkansas AR29$154−41%$132 – $281
Mississippi MS44$153−42%$94 – $286
West Virginia WV30$152−42%$65 – $331
Michigan MI63$147−44%$104 – $285
Tennessee TN58$128−51%$66 – $328
Louisiana LA39$122−53%$64 – $239
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 $262.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care1,666$264$144 – $539
Children’s56$418$178 – $639
Critical access795$253$125 – $417
Ownership
For-profit288$457$183 – $1,169
Government525$235$125 – $392
Non-profit1,704$259$136 – $463
System affiliation
Part of a system1,999$269$140 – $520
Independent523$250$130 – $437

Cash price vs list price

Median list price (chargemaster)$438
Median cash price$262
Cash as a share of list, median hospital67%

At the typical hospital, asking for the cash price cuts the list price by about 33%. 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

1,562 hospitals filed a usable inpatient cash price for this code. The median is $270 and the average of the middle 60% is $282; most fall between $143 and $471.

Cash price percentiles, inpatient, across 1,562 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
$101$161$270$428$641

The most expensive tenth of hospitals charges at least 6.4× what the cheapest tenth charges ($101 vs $641).

Of the 1,680 hospitals that filed this code inpatient, 1,562 gave a usable cash price; 20 carried a plausibility flag, 2 filed a number their own filing marks as not a price, 0 gave an estimate, and 96 a list price only.

How complete is this

2,522 of the 3,956 hospitals with a price file in our corpus (64%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 2,731 hospitals that filed this code at all gave us
Usable cash price — counted2,522
Cash price carrying a plausibility flag — shown on the compare tool, excluded here45
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded2
An estimate rather than a filed cash price — excluded1
A list price only, no cash figure — excluded161
Hospitals that filed this code2,731

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 25, 2026; the figures were computed September 25, 2026 from filings loaded through September 25, 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 Initial Consult Only Payable if Patient/Partner Does Not Go Through 99499 Workup.

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, high complexity (level 5) (CPT 99205) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-99205-office-visit-for-a-new-patient-high-complexity-level-5