Office Visit (Established, Moderate) Cost in Kansas

Office o/p est low 20 min

CPT 99213

Kansas Medicare physician rate (2026)

-6.5% vs national

Single statewide locality.

Kansas (Office)
$89.02
Non-facility physician fee
Kansas (Hospital)
$54.90
Facility physician fee
Private plan est.
$116–$178
~130–200% of Medicare
Cash / self-pay est.
$71–$134
~80–150% of Medicare

Your ZIP in Kansas

Enter a ZIP code for your part of Kansas, from Overland Park and the Kansas City suburbs to Wichita, Topeka, Lawrence, Salina, and the western High Plains.

What this number is

The figures on this page are 2026 Medicare physician allowed amounts for a specific CPT code: the professional fee, adjusted by geographic practice-cost indices. They are not a hospital chargemaster price, not your insurer's contracted rate, and not a quote. Hospital facility fees, anesthesia, implants, imaging reads, and pathology are billed separately when they apply. In Kansas the office and hospital physician lines for this CPT differ by $34.12.

National vs Kansas

National office$95.19
National hospital (physician)$57.45
Kansas vs national6% below the national office rate of $95.19

Where Kansas ranks for this CPT

Rank (lowest physician fee first)#4 of 51
Lowest stateArkansas ($86.86)
Highest stateAlaska ($118.72)

Office Visit (Established, Moderate) and how Kansas is priced

A single locality covers all of Kansas, with geographic indices in the lower national tier, so the published Medicare rates apply evenly from the Kansas City suburbs to the far western High Plains. Notably, the Kansas side of the Kansas City metro prices under the statewide Kansas locality while the Missouri side has its own metro locality, meaning the two halves of one city carry different approved amounts. Beyond that quirk, Kansas pricing is straightforwardly uniform. Wichita, Topeka, and rural Kansas all share the same adjustments.

The Kansas City metro and Wichita hold most of the state's specialists, with the academic medical center on the Kansas side of the metro serving as the top referral point. Western Kansas is genuinely frontier in places, with long distances to any hospital that performs advanced procedures, and some High Plains residents cross into Colorado or Nebraska for care. Critical access hospitals carry much of the rural load.

This procedure: This is the routine follow-up appointment of American medicine: an established-patient office visit of low-to-moderate complexity, such as a blood pressure check with a medication refill, a stable chronic condition review, or a minor new complaint. Billed by time it covers 20 to 29 minutes on the visit date. It is among the most frequently billed codes in the entire healthcare system, the standard quick-but-real doctor visit.

What Is Office Visit (Established, Moderate)?

This is the routine follow-up appointment of American medicine: an established-patient office visit of low-to-moderate complexity, such as a blood pressure check with a medication refill, a stable chronic condition review, or a minor new complaint. Billed by time it covers 20 to 29 minutes on the visit date. It is among the most frequently billed codes in the entire healthcare system, the standard quick-but-real doctor visit.

What Affects the Cost

  • Established-patient status keeps the price below any new-patient visit; this level is typically the cheapest substantive visit on a fee schedule after the minimal 99212.
  • Hospital-owned clinics attach facility fees that can exceed the visit fee itself, turning a modest checkup into a two-part bill.
  • In-visit extras like rapid tests, ECGs, or injections each bill on top.
  • Chronic disease management means this visit recurs several times a year indefinitely, so its price is a recurring subscription in practice.
  • Telehealth versions bill the same code, sometimes with different plan cost sharing than in-person.

Questions to Ask Before Booking

  • 1.What is my copay or the negotiated rate for a level-three established visit here?
  • 2.Will anything done today, tests or injections, be billed on top of the visit?
  • 3.Does this clinic charge a facility fee on office visits?
  • 4.How many follow-ups per year should I expect for my condition, and can any be telehealth?
  • 5.Is a telehealth visit cheaper under my plan than coming in?

Office Visit (Established, Moderate) in Kansas: questions

How much does office visit (established, moderate) cost in Kansas?

Kansas is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 99213 is $89.02 in an office and $54.90 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Does the rate change inside Kansas?

Not on the physician fee schedule. Kansas 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.

What will a Medicare patient owe for the physician fee?

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $18 for the office physician line or $11 for the hospital physician line in Kansas. Medigap may cover that 20%. This is not the hospital facility fee.

Is this the full office visit (established, moderate) bill in Kansas?

No. $89.02 is the Medicare physician allowed amount for CPT 99213. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Kansas ranks #4 of 51 states on this physician line (6% below the national office rate of $95.19).

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.