Office Visit (New, Low) Cost in North Dakota
Office o/p new low 30 min
$114.40North Dakota physician fee2026 Medicare office rate- ✓Your ZIP's wage-adjusted hospital and surgery centre rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
North Dakota Medicare physician rate (2026)
-2.7% vs nationalSingle statewide locality.
Your ZIP in North Dakota
Enter a ZIP code for your part of North Dakota, whether Fargo, Bismarck, Grand Forks, Minot, or the farm and oil country in between.
What office visit (new, low) costs at hospitals near you
Everything above is a national average. The hospital you pick in North Dakota 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.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
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 North Dakota the office and hospital physician lines for this CPT differ by $46.10.
National vs North Dakota
Where North Dakota ranks for this CPT
Office Visit (New, Low) and how North Dakota is priced
North Dakota's entire fee schedule flows through one statewide locality whose geographic indices sit near the national floor, lifted partly by the work index floor CMS applies to low-cost states. Fargo and a prairie town on the Canadian border publish identical Medicare-approved amounts. With no metro large enough to justify its own locality, the state is among the most straightforward in the country for Medicare pricing. Oil-patch growth in the west changed local economies but not the fee schedule structure.
Fargo and Bismarck are the state's two care anchors, each dominated by large regional systems that also reach into Minnesota, South Dakota, and Montana, with Grand Forks and Minot serving their own areas. Much of rural North Dakota depends on critical access hospitals, and winter travel adds a genuine planning constraint. Some eastern residents cross into Minnesota for care, particularly toward Fargo-Moorhead's twin market.
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?
Other featured procedures in North Dakota
Office Visit (New, Low) in other states
Office Visit (New, Low) in North Dakota: questions
North Dakota is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 99203 is $114.40 in an office and $68.30 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. North Dakota 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 $23 for the office physician line or $14 for the hospital physician line in North Dakota. Medigap may cover that 20%. This is not the hospital facility fee.
No. $114.40 is the Medicare physician allowed amount for CPT 99203. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. North Dakota ranks #24 of 51 states on this physician line (3% below the national office rate of $117.57).