How Much Does an Office Visit (New, High) Cost in Kansas?
Office o/p new hi 60 min
$220.49Kansas physician fee2026 Medicare office rateUnder 2026 Medicare rates, an office visit (new, high) costs about $220 in Kansas. When it is billed from a hospital-based clinic, the physician is paid about $151 and the hospital adds its own facility fee.
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Kansas Medicare physician rate (2026)
-6.9% vs nationalSingle statewide locality.
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 office visit (new, high) costs at hospitals near you
Everything above is a national average. The hospital you pick in Kansas 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.
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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 center 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 Kansas the office and hospital physician lines for this CPT differ by $69.14.
National vs Kansas
Where Kansas ranks for this CPT
Office Visit (New, High) 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 highest-level new-patient office visit, reserved for genuinely complex first encounters: multiple serious conditions, a diagnosis that could threaten life or function, or decisions about major interventions. Billed by time, it means 60 to 74 minutes with the clinician on the visit date. Typical examples include a first oncology consultation, a complicated multi-system workup, or a new patient with several unstable chronic diseases.
What Is Office Visit (New, High)?
This is the highest-level new-patient office visit, reserved for genuinely complex first encounters: multiple serious conditions, a diagnosis that could threaten life or function, or decisions about major interventions. Billed by time, it means 60 to 74 minutes with the clinician on the visit date. Typical examples include a first oncology consultation, a complicated multi-system workup, or a new patient with several unstable chronic diseases.
What Affects the Cost
- –It is the most expensive standard office visit code, and practices reserve it for their longest, most involved new consultations.
- –The specialists who bill it most, oncologists, rheumatologists, complex-care internists, tend to practice in hospital systems where facility fees compound the professional charge.
- –Visits this complex almost always launch expensive diagnostics: advanced imaging, biopsies, or specialty labs, each billed separately.
- –Prolonged-service add-on codes attach beyond 74 minutes, extending the charge further.
- –Second-opinion consultations at academic centers often bill at this level with academic-center pricing.
Questions to Ask Before Booking
- 1.What is the charge for this highest-level consultation, including any facility fee?
- 2.Does my plan need a referral on file before this visit?
- 3.Which of the tests and treatments you are recommending need prior authorization?
- 4.Is every provider involved in my workup, radiology, pathology, labs, in my network?
- 5.If this is a second opinion, does my plan have a program that covers it in full?
Other featured procedures in Kansas
Office Visit (New, High) in other states
Office Visit (New, High) in Kansas: questions
Under 2026 Medicare rates, an office visit (new, high) costs about $220 in Kansas. When it is billed from a hospital-based clinic, the physician is paid about $151 and the hospital adds its own facility fee. Kansas is a single Medicare locality, so the physician rate is the same statewide.
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.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $44 for the office physician line or $30 for the hospital physician line in Kansas. Medigap may cover that 20%. This is not the hospital facility fee.
No. $220.49 is the Medicare physician allowed amount for CPT 99205. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Kansas ranks #5 of 51 states on this physician line (7% below the national office rate of $236.81).