Commercial rate index · metro cell
Winston-Salem healthcare rate index
Commercial contracted rates in Winston-Salem, NC run 0.81x the national Medicare fee schedule across the office-visit basket. Index 84.3, where 100 is the national standard.
Index 84.3
0.81x Medicare
47,680 verified rate points
8/8 basket codes
state index 89.2
The basket in Winston-Salem
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 | 6,236 | Benchmark |
| 99203 | Office visit, new patient, 30-44 min | $86.00 | 0.78x | 5,145 | Benchmark |
| 99204 | Office visit, new patient, 45-59 min | $141.97 | 0.85x | 5,133 | Benchmark |
| 99205 | Office visit, new patient, 60-74 min | $273.84 | 1.25x | 10,642 | Benchmark |
| 99212 | Office visit, established patient, 10-19 min | $47.73 | 0.84x | 5,081 | Benchmark |
| 99213 | Office visit, established patient, 20-29 min | $57.62 | 0.62x | 5,140 | Benchmark |
| 99214 | Office visit, established patient, 30-39 min | $101.45 | 0.77x | 5,173 | Benchmark |
| 99215 | Office visit, established patient, 40-54 min | $124.70 | 0.67x | 5,130 | Benchmark |
Medians across the full verified distribution of practice-level contracted rates in this CBSA (49180). 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.
Winston-Salem 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, Winston-Salem, NC. Reddenda. https://reddenda.health/atlas/nc/winston-salem-49180/
Derivation federally mandated TiC MRFs, verified to provider identityCBSA 49180 · metro grainas of 2026-07-15 · methodology v1.0