CPT99213

Office Visit (Established, Moderate) Cost in Wyoming

Office o/p est low 20 min

$94.41Wyoming physician fee2026 Medicare office rate
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Wyoming Medicare physician rate (2026)

-0.8% vs national

Single statewide locality.

Wyoming (Hospital)
$56.67
Facility physician fee
Private plan est.
$123–$189
~130–200% of Medicare
Cash / self-pay est.
$76–$142
~80–150% of Medicare

Your ZIP in Wyoming

Enter a ZIP code for your part of Wyoming, whether Cheyenne, Casper, Laramie, Gillette, Sheridan, Rock Springs, or the Jackson Hole and Wind River country.

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

Everything above is a national average. The hospital you pick in Wyoming 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 Wyoming the office and hospital physician lines for this CPT differ by $37.74.

National vs Wyoming

National office$95.19
National hospital (physician)$57.45
Wyoming vs nationalwithin 2% of the national office rate of $95.19

Where Wyoming ranks for this CPT

Rank (lowest physician fee first)#29 of 51
Lowest stateArkansas ($86.86)
Highest stateAlaska ($118.72)

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

The least populous state in the nation, Wyoming is priced through one statewide locality whose indices sit in the lowest national tier, supported by the rural work index floor. Cheyenne, Casper, and a mountain hamlet in the Winds all share identical Medicare-approved amounts. With no city large enough to form its own market in CMS's eyes, the fee schedule is as simple here as anywhere in America. The hard part of Wyoming health care has never been the published price; it is reaching a provider who performs the procedure.

Wyoming has no academic medical center of its own, so complex care routinely means a trip to Denver, Salt Lake City, Billings, or Fort Collins, and residents plan major procedures around those referral routes. Cheyenne, Casper, Jackson, and Gillette support the state's larger hospitals, while frontier counties depend on small critical access facilities. Distances and winter weather make telehealth and travel planning unusually important here.

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 Wyoming: questions

Wyoming is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 99213 is $94.41 in an office and $56.67 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Wyoming 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 $19 for the office physician line or $11 for the hospital physician line in Wyoming. Medigap may cover that 20%. This is not the hospital facility fee.

No. $94.41 is the Medicare physician allowed amount for CPT 99213. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Wyoming ranks #29 of 51 states on this physician line (within 2% of 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.