CPT99205

Office Visit (New, High) Cost in Mississippi

Office o/p new hi 60 min

$218.68Mississippi 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)

-7.7% vs national

Single statewide locality.

Mississippi (Hospital)
$152.82
Facility physician fee
Private plan est.
$284–$437
~130–200% of Medicare
Cash / self-pay est.
$175–$328
~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 (new, high) 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 $65.86.

National vs Mississippi

National office$236.81
National hospital (physician)$160.32
Mississippi vs national8% below the national office rate of $236.81

Where Mississippi ranks for this CPT

Rank (lowest physician fee first)#3 of 51
Lowest stateArkansas ($215.77)
Highest stateAlaska ($296.88)

Office Visit (New, High) 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 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?

Office Visit (New, High) in Mississippi: questions

Mississippi is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 99205 is $218.68 in an office and $152.82 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 $44 for the office physician line or $31 for the hospital physician line in Mississippi. Medigap may cover that 20%. This is not the hospital facility fee.

No. $218.68 is the Medicare physician allowed amount for CPT 99205. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Mississippi ranks #3 of 51 states on this physician line (8% below the national office rate of $236.81).

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.