CPT99203

Office Visit (New, Low) Cost in Florida

Office o/p new low 30 min

$122.82Florida physician fee2026 Medicare office rate
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Florida Medicare physician rate (2026)

+4.5% vs national

Average of 3 localities. Office range $117.67–$128.15.

Florida (Hospital)
$76.58
Facility physician fee
Private plan est.
$160–$246
~130–200% of Medicare
Cash / self-pay est.
$98–$184
~80–150% of Medicare

Your ZIP in Florida

Because Florida uses multiple localities, check your ZIP code specifically, whether you are in Miami, Fort Lauderdale, West Palm Beach, Orlando, Tampa Bay, Jacksonville, or the Panhandle.

What office visit (new, low) costs at hospitals near you

Everything above is a national average. The hospital you pick in Florida 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.

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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 Florida the office and hospital physician lines for this CPT differ by $46.24.

National vs Florida

National office$117.57
National hospital (physician)$71.48
Florida vs national4% above the national office rate of $117.57

Where Florida ranks for this CPT

Rank (lowest physician fee first)#43 of 51
Lowest stateArkansas ($106.69)
Highest stateAlaska ($145.71)

CPT 99203 by Florida locality

LocalityOffice
miami$128.15
fort lauderdale$122.65
rest of florida$117.67

PE GPCI ranges from 0.956 to 1.041 in Florida. That index is why the same CPT is not one price statewide.

Office Visit (New, Low) and how Florida is priced

Florida is split into a handful of Medicare payment localities rather than priced statewide: Miami carries its own high-cost locality, the Fort Lauderdale area is separately priced, and the remainder of the state, from Jacksonville to the Panhandle, shares rest-of-state pricing. That structure means South Florida procedures carry higher Medicare-approved amounts than identical care in Orlando, Tampa, or rural North Florida. The Miami locality in particular ranks among the more expensive in the eastern United States. For a state with this many Medicare beneficiaries, knowing which locality your ZIP falls in is genuinely useful.

Florida has the nation's most Medicare-driven health economy, and its markets are intensely competitive in the big retiree corridors along both coasts. South Florida is known for high utilization and a dense supply of specialists, while inland and Panhandle counties can be thin on subspecialty care. Seasonal residents should note that prices follow where care is delivered, so a winter procedure in Naples prices differently than one back home up north.

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?

Office Visit (New, Low) in Florida: questions

The 2026 Medicare physician office rate for CPT 99203 averages $122.82 across 3 Florida localities, from $117.67 in REST OF FLORIDA to $128.15 in MIAMI. The hospital physician rate averages $76.58. Enter a ZIP for the exact locality.

Yes. CMS splits Florida into 3 payment localities. For this CPT the office physician fee spans $10.48 from the lowest to highest locality. Because Florida uses multiple localities, check your ZIP code specifically, whether you are in Miami, Fort Lauderdale, West Palm Beach, Orlando, Tampa Bay, Jacksonville, or the Panhandle.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $25 for the office physician line or $15 for the hospital physician line in Florida. Medigap may cover that 20%. This is not the hospital facility fee.

No. $122.82 is the Medicare physician allowed amount for CPT 99203. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Florida ranks #43 of 51 states on this physician line (4% above the national office rate of $117.57).

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.