Commercial rate index · metro cell
Wilmington healthcare rate index
Commercial contracted rates in Wilmington, NC run 0.81x the national Medicare fee schedule across the office-visit basket. Index 84.2, where 100 is the national standard.
Index 84.2
0.81x Medicare
43,004 verified rate points
8/8 basket codes
state index 89.2
The basket in Wilmington
as of 2026-07-15| CPT | Service | Metro median | vs Medicare | Rate points | Tier |
|---|---|---|---|---|---|
| 99202 | Office visit, new patient, 15-29 min | $66.22 | 0.93x | 5,487 | Benchmark |
| 99203 | Office visit, new patient, 30-44 min | $86.00 | 0.78x | 4,824 | Benchmark |
| 99204 | Office visit, new patient, 45-59 min | $141.97 | 0.85x | 4,880 | Benchmark |
| 99205 | Office visit, new patient, 60-74 min | $273.84 | 1.25x | 8,427 | Benchmark |
| 99212 | Office visit, established patient, 10-19 min | $47.64 | 0.84x | 4,812 | Benchmark |
| 99213 | Office visit, established patient, 20-29 min | $57.62 | 0.62x | 4,852 | Benchmark |
| 99214 | Office visit, established patient, 30-39 min | $102.20 | 0.78x | 4,861 | Benchmark |
| 99215 | Office visit, established patient, 40-54 min | $126.85 | 0.68x | 4,861 | Benchmark |
Medians across the full verified distribution of practice-level contracted rates in this CBSA (48900). 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.
Wilmington prints below its state cell (North Carolina at 89.2) and below the national standard of 100.
Cite this page
Source: Reddenda Commercial Rate Atlas, Wilmington, NC. Reddenda. https://reddenda.health/atlas/nc/wilmington-48900/
Derivation federally mandated TiC MRFs, verified to provider identityCBSA 48900 · metro grainas of 2026-07-15 · methodology v1.0