Commercial rate index · metro cell
Philadelphia-Camden-Wilmington healthcare rate index
Commercial contracted rates in Philadelphia-Camden-Wilmington, PA-NJ-DE-MD run 1.01x the national Medicare fee schedule across the office-visit basket. Index 105.2, where 100 is the national standard.
Index 105.2
1.01x Medicare
136,390 verified rate points
8/8 basket codes
state index 102.5
The basket in Philadelphia-Camden-Wilmington
as of 2026-07-15| CPT | Service | Metro median | vs Medicare | Rate points | Tier |
|---|---|---|---|---|---|
| 99202 | Office visit, new patient, 15-29 min | $84.82 | 1.19x | 17,453 | Benchmark |
| 99203 | Office visit, new patient, 30-44 min | $116.04 | 1.05x | 12,801 | Benchmark |
| 99204 | Office visit, new patient, 45-59 min | $175.84 | 1.05x | 15,188 | Benchmark |
| 99205 | Office visit, new patient, 60-74 min | $228.97 | 1.04x | 29,694 | Benchmark |
| 99212 | Office visit, established patient, 10-19 min | $54.28 | 0.95x | 10,533 | Benchmark |
| 99213 | Office visit, established patient, 20-29 min | $88.59 | 0.96x | 18,204 | Benchmark |
| 99214 | Office visit, established patient, 30-39 min | $129.26 | 0.98x | 19,949 | Benchmark |
| 99215 | Office visit, established patient, 40-54 min | $180.89 | 0.97x | 12,568 | Benchmark |
Medians across the full verified distribution of practice-level contracted rates in this CBSA (37980). 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.
Philadelphia-Camden-Wilmington prints above its state cell (Pennsylvania at 102.5) and above the national standard of 100.
Cite this page
Source: Reddenda Commercial Rate Atlas, Philadelphia-Camden-Wilmington, PA-NJ-DE-MD. Reddenda. https://reddenda.health/atlas/pa/philadelphia-camden-wilmington-37980/
Derivation federally mandated TiC MRFs, verified to provider identityCBSA 37980 · metro grainas of 2026-07-15 · methodology v1.0