Office Visit (Established, Moderate) Cost in California
Office o/p est low 20 min
California Average Cost (2026)
+9.6% vs national avgAverage across 29 Medicare localities in California
National Average
State Ranking
Cost by Region in California
| Region | Office Rate |
|---|---|
| san jose-sunnyvale-santa clara (san benito cnty) | $120.13 |
| san jose-sunnyvale-santa clara (santa clara cnty) | $119.71 |
| san francisco-oakland-berkeley (marin cnty) | $117.69 |
| san francisco-oakland-berkeley (san francisco/san mateo/alameda/contra costa cnty) | $117.58 |
| napa | $111.96 |
| vallejo | $111.81 |
| santa rosa-petaluma | $106.22 |
| santa cruz-watsonville | $105.19 |
| los angeles-long beach-anaheim (los angeles/orange cnty) | $104.89 |
| san diego-chula vista-carlsbad | $104.68 |
| oxnard-thousand oaks-ventura | $104.15 |
| sacramento-roseville-folsom | $103.31 |
| santa maria-santa barbara | $103.11 |
| salinas | $102.90 |
| san luis obispo-paso robles | $101.31 |
| riverside-san bernardino-ontario | $100.21 |
| bakersfield | $99.52 |
| el centro | $99.23 |
| chico | $99.22 |
| fresno | $99.22 |
| hanford-corcoran | $99.22 |
| madera | $99.22 |
| merced | $99.22 |
| modesto | $99.22 |
| redding | $99.22 |
| stockton | $99.22 |
| visalia | $99.22 |
| yuba city | $99.22 |
| rest of california | $99.22 |
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About Office Visit (Established, Moderate) Costs in California
The average Medicare reimbursement for office visit (established, moderate) in California is $104.31 for an office setting and $59.65 in a hospital. This is about 10% higher than the national average of $95.19.
Medicare patients typically pay 20% of the Medicare rate after meeting their deductible. For this procedure in California, that would be roughly $21 for an office visit or $12 in a hospital setting.
Private insurance plans in California typically pay between 130% and 200% of Medicare rates for this procedure, putting the total somewhere between $136 and $209.
Without insurance, you may be able to negotiate a cash discount. Many providers in California will reduce their fees by 20% to 40% for self-pay patients. Always ask about cash pricing before scheduling your procedure.
Ways to Save on Office Visit (Established, Moderate)
Compare Insurance Plans
Uninsured? Comparing marketplace plans in California could save you thousands on procedures like this.
Compare plans on eHealth →Try Telehealth First
Many consultations can be done virtually for $50-100, saving hundreds vs an in-person visit.
Book on Sesame Care →Save on Prescriptions
If this procedure leads to a prescription, check discount cards for up to 80% savings.
Check prices on GoodRx →Some links are affiliate links. We may earn a commission at no extra cost to you.
More ways to save →Other Procedures in California
Office Visit (Established, Moderate) Cost by State
Office Visit (Established, Moderate) in California: Frequently Asked Questions
How much does office visit (established, moderate) cost in California?
The average 2026 Medicare rate for office visit (established, moderate) (CPT 99213) in California is $104.31 in an office setting and $59.65 in a hospital. Private insurance typically pays $136 to $209, and self-pay cash prices often run $83 to $156.
Is office visit (established, moderate) cheaper in California than the national average?
California is about 10% higher than the national average of $95.19. Across all states, California ranks #47 of 49 for this procedure. The cheapest state is Arkansas ($86.86) and the most expensive is Alaska ($118.72).
What will I pay out of pocket for office visit (established, moderate) in California with Medicare?
Medicare patients typically pay 20% of the Medicare rate after meeting their deductible. In California that is roughly $21 for an office visit or $12 in a hospital setting.
How can I save on office visit (established, moderate) in California?
Ask providers for a cash or self-pay price before scheduling; many in California reduce fees 20% to 40% for self-pay patients. If you are uninsured, comparing marketplace plans, using telehealth for consultations, and checking prescription discount cards can cut costs further.