Commercial rate index · metro cell
New York-Newark-Jersey City healthcare rate index
Commercial contracted rates in New York-Newark-Jersey City, NY-NJ run 0.83x the national Medicare fee schedule across the office-visit basket. Index 86.1, where 100 is the national standard.
Index 86.1
0.83x Medicare
1,646,812 verified rate points
8/8 basket codes
state index 83.5
The basket in New York-Newark-Jersey City
as of 2026-07-15| CPT | Service | Metro median | vs Medicare | Rate points | Tier |
|---|---|---|---|---|---|
| 99202 | Office visit, new patient, 15-29 min | $75.41 | 1.06x | 232,747 | Benchmark |
| 99203 | Office visit, new patient, 30-44 min | $97.33 | 0.88x | 207,063 | Benchmark |
| 99204 | Office visit, new patient, 45-59 min | $159.62 | 0.96x | 160,926 | Benchmark |
| 99205 | Office visit, new patient, 60-74 min | $242.74 | 1.10x | 244,556 | Benchmark |
| 99212 | Office visit, established patient, 10-19 min | $43.89 | 0.77x | 214,642 | Benchmark |
| 99213 | Office visit, established patient, 20-29 min | $70.35 | 0.76x | 183,321 | Benchmark |
| 99214 | Office visit, established patient, 30-39 min | $65.17 | 0.49x | 200,532 | Benchmark |
| 99215 | Office visit, established patient, 40-54 min | $124.95 | 0.67x | 203,025 | Benchmark |
Medians across the full verified distribution of practice-level contracted rates in this CBSA (35620). 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.
New York-Newark-Jersey City prints above its state cell (New York at 83.5) and below the national standard of 100.
Cite this page
Source: Reddenda Commercial Rate Atlas, New York-Newark-Jersey City, NY-NJ. Reddenda. https://reddenda.health/atlas/ny/new-york-newark-jersey-city-35620/
Derivation federally mandated TiC MRFs, verified to provider identityCBSA 35620 · metro grainas of 2026-07-15 · methodology v1.0