CPT99203

Office Visit (New, Low) Cost in Tennessee

Office o/p new low 30 min

$109.75Tennessee physician fee2026 Medicare office rate
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Tennessee Medicare physician rate (2026)

-6.7% vs national

Single statewide locality.

Tennessee (Hospital)
$67.85
Facility physician fee
Private plan est.
$143–$220
~130–200% of Medicare
Cash / self-pay est.
$88–$165
~80–150% of Medicare

Your ZIP in Tennessee

Enter a ZIP code for your part of Tennessee, whether Nashville, Memphis, Knoxville, Chattanooga, the Tri-Cities, or the rural plateau and delta counties.

What office visit (new, low) costs at hospitals near you

Everything above is a national average. The hospital you pick in Tennessee 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 Tennessee the office and hospital physician lines for this CPT differ by $41.90.

National vs Tennessee

National office$117.57
National hospital (physician)$71.48
Tennessee vs national7% below the national office rate of $117.57

Where Tennessee ranks for this CPT

Rank (lowest physician fee first)#7 of 51
Lowest stateArkansas ($106.69)
Highest stateAlaska ($145.71)

Office Visit (New, Low) and how Tennessee is priced

Tennessee's Medicare rates come from one statewide locality with below-average geographic indices, so Memphis, Nashville, Knoxville, and Chattanooga all publish the same approved amounts despite being four distinct metro markets. The uniform locality stretches across a state that spans two time zones and several regional economies. Nashville's boom has raised local practice costs faster than the statewide averages that feed the indices. For patients, the fee schedule is identical statewide; the markets around it are anything but.

Nashville is the corporate capital of American hospital operations, home to major for-profit chains, alongside a prominent academic medical center, while Memphis anchors care for the Mid-South including parts of Mississippi and Arkansas. Knoxville and Chattanooga serve East Tennessee, and the rural Cumberland Plateau and West Tennessee counties have seen multiple hospital closures. Cross-border patient flows into Tennessee's metros are heavy from every neighboring state.

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?

Office Visit (New, Low) in Tennessee: questions

Tennessee is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 99203 is $109.75 in an office and $67.85 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Tennessee 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 $22 for the office physician line or $14 for the hospital physician line in Tennessee. Medigap may cover that 20%. This is not the hospital facility fee.

No. $109.75 is the Medicare physician allowed amount for CPT 99203. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Tennessee ranks #7 of 51 states on this physician line (7% below the national office rate of $117.57).

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.