CPT99203

Office Visit (New, Low) Cost in Georgia

Office o/p new low 30 min

$116.00Georgia physician fee2026 Medicare office rate
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Georgia Medicare physician rate (2026)

-1.3% vs national

Average of 2 localities. Office range $112.25–$119.75.

Georgia (Hospital)
$72.03
Facility physician fee
Private plan est.
$151–$232
~130–200% of Medicare
Cash / self-pay est.
$93–$174
~80–150% of Medicare

Your ZIP in Georgia

Look up your ZIP to see whether Atlanta-area or rest-of-state pricing applies, from the metro counties to Savannah, Augusta, Columbus, Macon, and rural south Georgia.

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

Everything above is a national average. The hospital you pick in Georgia 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 Georgia the office and hospital physician lines for this CPT differ by $43.97.

National vs Georgia

National office$117.57
National hospital (physician)$71.48
Georgia vs nationalwithin 2% of the national office rate of $117.57

Where Georgia ranks for this CPT

Rank (lowest physician fee first)#28 of 51
Lowest stateArkansas ($106.69)
Highest stateAlaska ($145.71)

CPT 99203 by Georgia locality

LocalityOffice
atlanta$119.75
rest of georgia$112.25

PE GPCI ranges from 0.892 to 1.016 in Georgia. That index is why the same CPT is not one price statewide.

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

Georgia divides into an Atlanta metro locality and a rest-of-state locality, so the fee schedule itself recognizes the cost gap between the capital region and the rest of the state. Atlanta's higher wages and rents translate into higher Medicare-approved amounts inside its locality, while Savannah, Augusta, Columbus, Macon, and rural Georgia share the lower rest-of-state pricing. The split is one of the cleaner examples of a two-tier state in the fee schedule. Patients near the locality boundary can see different approved amounts a short drive apart.

Metro Atlanta concentrates the state's academic medicine and most of its subspecialists, drawing referrals from across the Southeast. Outside the metro, south Georgia has seen repeated rural hospital closures, leaving longer trips for even routine procedures in some counties. Augusta and Savannah serve as important secondary hubs, and border residents sometimes cross into Chattanooga, Tallahassee, or Jacksonville for care.

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 Georgia: questions

The 2026 Medicare physician office rate for CPT 99203 averages $116.00 across 2 Georgia localities, from $112.25 in REST OF GEORGIA to $119.75 in ATLANTA. The hospital physician rate averages $72.03. Enter a ZIP for the exact locality.

Yes. CMS splits Georgia into 2 payment localities. For this CPT the office physician fee spans $7.50 from the lowest to highest locality. Look up your ZIP to see whether Atlanta-area or rest-of-state pricing applies, from the metro counties to Savannah, Augusta, Columbus, Macon, and rural south Georgia.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $23 for the office physician line or $14 for the hospital physician line in Georgia. Medigap may cover that 20%. This is not the hospital facility fee.

No. $116.00 is the Medicare physician allowed amount for CPT 99203. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Georgia ranks #28 of 51 states on this physician line (within 2% of 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.