Commercial rate index · metro cell
Hagerstown-Martinsburg healthcare rate index
Commercial contracted rates in Hagerstown-Martinsburg, MD-WV run 0.98x the national Medicare fee schedule across the office-visit basket. Index 101.6, where 100 is the national standard.
Index 101.6
0.98x Medicare
2,992 verified rate points
8/8 basket codes
state index 104.2
The basket in Hagerstown-Martinsburg
as of 2026-07-15| CPT | Service | Metro median | vs Medicare | Rate points | Tier |
|---|---|---|---|---|---|
| 99202 | Office visit, new patient, 15-29 min | $74.63 | 1.05x | 631 | Benchmark |
| 99203 | Office visit, new patient, 30-44 min | $112.56 | 1.02x | 240 | Benchmark |
| 99204 | Office visit, new patient, 45-59 min | $163.13 | 0.98x | 235 | Benchmark |
| 99205 | Office visit, new patient, 60-74 min | $243.19 | 1.11x | 1,026 | Benchmark |
| 99212 | Office visit, established patient, 10-19 min | $55.45 | 0.98x | 176 | Benchmark |
| 99213 | Office visit, established patient, 20-29 min | $88.85 | 0.96x | 281 | Benchmark |
| 99214 | Office visit, established patient, 30-39 min | $125.90 | 0.96x | 236 | Benchmark |
| 99215 | Office visit, established patient, 40-54 min | $176.71 | 0.95x | 167 | Benchmark |
Medians across the full verified distribution of practice-level contracted rates in this CBSA (25180). Floor: 11 verified rate points per code, non-degenerate spread. Denominator: CMS PFS CY2026 national non-facility. Methodology v1.0.
Documented reimbursement figures are modeled, not guaranteed. Derived from federally mandated Transparency in Coverage data (45 CFR 147.212). No PHI.
The market around it.
Hagerstown-Martinsburg prints below its state cell (Maryland at 104.2) and above the national standard of 100.
Cite this page
Source: Reddenda Commercial Rate Atlas, Hagerstown-Martinsburg, MD-WV. Reddenda. https://reddenda.health/atlas/md/hagerstown-martinsburg-25180/
Derivation federally mandated TiC MRFs, verified to provider identityCBSA 25180 · metro grainas of 2026-07-15 · methodology v1.0