CPT99213

Office Visit (Established, Moderate) Cost in Mississippi

Office o/p est low 20 min

$87.63Mississippi physician fee2026 Medicare office rate
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Mississippi Medicare physician rate (2026)

-7.9% vs national

Single statewide locality.

Mississippi (Hospital)
$55.13
Facility physician fee
Private plan est.
$114–$175
~130–200% of Medicare
Cash / self-pay est.
$70–$131
~80–150% of Medicare

Your ZIP in Mississippi

Run a ZIP lookup for your area, whether metro Jackson, the Gulf Coast from Biloxi to Pascagoula, Hattiesburg, Tupelo, or the rural Delta.

What office visit (established, moderate) costs at hospitals near you

Everything above is a national average. The hospital you pick in Mississippi 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 Mississippi the office and hospital physician lines for this CPT differ by $32.50.

National vs Mississippi

National office$95.19
National hospital (physician)$57.45
Mississippi vs national8% below the national office rate of $95.19

Where Mississippi ranks for this CPT

Rank (lowest physician fee first)#2 of 51
Lowest stateArkansas ($86.86)
Highest stateAlaska ($118.72)

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

Mississippi operates as one statewide payment locality, and its geographic indices are among the very lowest in the fee schedule, so Medicare-approved amounts here are close to the national floor. Jackson, the Gulf Coast, and the Delta all share identical adjustments. In a state where practice costs and wages run well below national averages, the low locality factors track the underlying economics. The statewide figures on this site therefore apply almost unchanged wherever in Mississippi you are treated.

Jackson is home to the state's academic medical center and functions as the referral point of last resort for much of Mississippi, while the Gulf Coast and cities like Tupelo, Hattiesburg, and Meridian anchor regional care. The Delta faces some of the most serious rural access challenges in the nation, with hospital closures and long distances compounding high rates of chronic illness. Border residents often use Memphis, Mobile, or New Orleans providers.

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 Mississippi: questions

Mississippi is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 99213 is $87.63 in an office and $55.13 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Mississippi 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 $18 for the office physician line or $11 for the hospital physician line in Mississippi. Medigap may cover that 20%. This is not the hospital facility fee.

No. $87.63 is the Medicare physician allowed amount for CPT 99213. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Mississippi ranks #2 of 51 states on this physician line (8% 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.