CPT99215

Office Visit (Established, High) Cost in Alaska

Office o/p est hi 40 min

$241.97Alaska physician fee2026 Medicare office rate
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Alaska Medicare physician rate (2026)

+25.8% vs national

Single statewide locality.

Alaska (Hospital)
$170.83
Facility physician fee
Private plan est.
$315–$484
~130–200% of Medicare
Cash / self-pay est.
$194–$363
~80–150% of Medicare

Your ZIP in Alaska

Look up your ZIP code to see Alaska's adjusted rates, whether you are in Anchorage, Fairbanks, Juneau, the Mat-Su Valley, or a fly-in community off the road system.

What office visit (established, high) costs at hospitals near you

Everything above is a national average. The hospital you pick in Alaska moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.

What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Alaska the office and hospital physician lines for this CPT differ by $71.14.

National vs Alaska

National office$192.39
National hospital (physician)$125.59
Alaska vs national26% above the national office rate of $192.39

Where Alaska ranks for this CPT

Rank (lowest physician fee first)#51 of 51
Lowest stateArkansas ($176.04)
Highest stateAlaska ($241.97)

Office Visit (Established, High) and how Alaska is priced

Alaska stands apart in the Medicare fee schedule: it is a single statewide locality, but federal law sets a permanent 1.5 floor on its physician work adjustment, the highest geographic treatment in the country. Combined with elevated practice expense indices that reflect the real cost of running a clinic in a remote state, Alaska's Medicare-approved amounts are consistently the highest of any state. Every community from Anchorage to the smallest bush village prices off the same locality, so the premium applies statewide rather than only in the cities.

Anchorage holds most of the state's specialists, and Fairbanks and Juneau add regional capacity, but many Alaskans still fly to Anchorage or even Seattle for complex procedures. Travel and lodging can rival the medical bill itself for residents of remote communities, which makes planning ahead unusually important here. Tribal health facilities also play a large role in care delivery across much of the state.

This procedure: This is the highest established-patient office visit level, for encounters involving high-complexity decisions: severe worsening of a chronic illness, problems that threaten life or bodily function, or decisions about hospitalization, major surgery, or high-risk drug therapy requiring intensive monitoring. Billed by time it means 40 to 54 minutes on the visit date. It is far less common than levels three and four, appearing when something significant is genuinely happening with your health.

What Is Office Visit (Established, High)?

This is the highest established-patient office visit level, for encounters involving high-complexity decisions: severe worsening of a chronic illness, problems that threaten life or bodily function, or decisions about hospitalization, major surgery, or high-risk drug therapy requiring intensive monitoring. Billed by time it means 40 to 54 minutes on the visit date. It is far less common than levels three and four, appearing when something significant is genuinely happening with your health.

What Affects the Cost

  • It carries the highest established-visit price, and visits at this level usually sit inside expensive care episodes: imminent hospitalizations, treatment escalations, or complex disease flares.
  • The decisions made here, starting high-risk medications, ordering urgent advanced imaging, arranging admission, each open substantial separate spending.
  • Prolonged-service add-on codes attach beyond 54 minutes, extending charges.
  • Specialist and academic-center billing at this level exceeds primary care rates.
  • Facility fees apply as always in hospital-owned settings, proportionally largest on the biggest visit codes.

Questions to Ask Before Booking

  • 1.What made today a level-five visit, and what is that price under my plan?
  • 2.Which of the urgent next steps you are ordering need authorization, and who handles the expedited requests?
  • 3.If admission is possible, does my plan require notification, and will you handle it?
  • 4.Are prolonged-service charges being added for today's visit length?
  • 5.Does my plan offer care management support that could cover some of this follow-up at no cost?

Office Visit (Established, High) in Alaska: questions

Alaska is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 99215 is $241.97 in an office and $170.83 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Alaska uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $48 for the office physician line or $34 for the hospital physician line in Alaska. Medigap may cover that 20%. This is not the hospital facility fee.

No. $241.97 is the Medicare physician allowed amount for CPT 99215. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Alaska ranks #51 of 51 states on this physician line (26% above the national office rate of $192.39).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.