Office Visit (New, Low) Cost in Colorado
Office o/p new low 30 min
$120.80Colorado physician fee2026 Medicare office rate- ✓Your ZIP's wage-adjusted hospital and surgery centre rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Colorado Medicare physician rate (2026)
+2.7% vs nationalSingle statewide locality.
Your ZIP in Colorado
Enter a ZIP code to compare your area of Colorado, from Denver, Boulder, Fort Collins, and Colorado Springs to Grand Junction, the mountain resort counties, and the Eastern Plains.
What office visit (new, low) costs at hospitals near you
Everything above is a national average. The hospital you pick in Colorado moves the bill more than anything else you control.
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 Colorado the office and hospital physician lines for this CPT differ by $49.04.
National vs Colorado
Where Colorado ranks for this CPT
Office Visit (New, Low) and how Colorado is priced
Colorado's physician fees are set through a single statewide locality, so the Front Range and the Western Slope share one set of geographic adjustments despite very different local economies. The state's indices run modestly above the national midpoint, reflecting Denver-area wages and rents averaged against lower-cost rural areas. Because the locality is unified, mountain resort towns do not carry a higher Medicare fee schedule even though their private-market prices are famously steep. That gap between Medicare's uniform pricing and wide private-price variation is a defining feature of the Colorado market.
Care is concentrated along the Front Range from Fort Collins through Denver to Colorado Springs and Pueblo, where several large systems and an academic medical center compete. Mountain and plains communities depend on smaller hospitals, and residents there commonly drive to Denver or Grand Junction for specialty procedures. Resort-area facilities can bill far above what the corridor cities charge, so location shopping pays off in this state.
This procedure: This is a new-patient office visit of low complexity: your first appointment with a practice in at least three years, for a problem that is relatively contained, such as a stable rash, a minor joint complaint, or a straightforward infection. The clinician takes your history, examines you, and forms a plan, typically across 30 to 44 minutes when billed by time. New-patient visits pay more than established-patient visits because building your baseline record takes longer.
What Is Office Visit (New, Low)?
This is a new-patient office visit of low complexity: your first appointment with a practice in at least three years, for a problem that is relatively contained, such as a stable rash, a minor joint complaint, or a straightforward infection. The clinician takes your history, examines you, and forms a plan, typically across 30 to 44 minutes when billed by time. New-patient visits pay more than established-patient visits because building your baseline record takes longer.
What Affects the Cost
- –New-patient codes price meaningfully above the equivalent established-patient visit, a one-time premium for joining a practice.
- –Hospital-owned practices add a facility fee to office visits that independent practices cannot, sometimes doubling the encounter cost.
- –Any labs, ECGs, or procedures done during the visit bill on top of the visit code.
- –Specialist new-patient visits at this same code level are billed at higher charge-master rates than primary care in many systems.
- –If your problem turns out more complex than expected, the visit may be coded a level higher (99204) at a higher price.
Questions to Ask Before Booking
- 1.Am I being seen as a new patient, and what is the price difference versus an established visit?
- 2.Is this practice hospital-owned, and will a facility fee be added to my visit?
- 3.What will any labs or tests today add to the bill?
- 4.If I also want my annual physical, will that be billed separately from this problem visit?
- 5.What is your self-pay price for this visit level if I have a high deductible?
Other featured procedures in Colorado
Office Visit (New, Low) in other states
Office Visit (New, Low) in Colorado: questions
Colorado is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 99203 is $120.80 in an office and $71.76 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. Colorado 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 $24 for the office physician line or $14 for the hospital physician line in Colorado. Medigap may cover that 20%. This is not the hospital facility fee.
No. $120.80 is the Medicare physician allowed amount for CPT 99203. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Colorado ranks #41 of 51 states on this physician line (3% above the national office rate of $117.57).