Code Reality Check
99202 reimbursement rate: Office visit, new patient, 15-29 min
Office visit, new patient, 15-29 min (CPT 99202) pays a median $170.88 in North Dakota and $58.60 in Kentucky, against a Medicare anchor of $71.16. 51 of 51 states clear the publication floor.
spread 2.9x top to bottom
Medicare anchor $71.16
51/51 states published
The 50-state spread
as of 2026-07-15| State | Median | vs Medicare | Band | Rate points | Tier |
|---|---|---|---|---|---|
| North Dakota | $170.88 | 2.40x | $76–$197 · P90 $202 | 2,618 | Benchmark |
| South Dakota | $168.30 | 2.37x | $71–$185 · P90 $202 | 2,555 | Benchmark |
| Massachusetts | $147.65 | 2.07x | $114–$178 · P90 $198 | 59,094 | Benchmark |
| Nebraska | $146.99 | 2.07x | $63–$161 · P90 $171 | 6,295 | Benchmark |
| Connecticut | $138.96 | 1.95x | $79–$199 · P90 $260 | 13,468 | Benchmark |
| Wisconsin | $123.12 | 1.73x | $74–$194 · P90 $268 | 61,948 | Benchmark |
| Oregon | $113.78 | 1.60x | $96–$173 · P90 $192 | 11,056 | Benchmark |
| New Hampshire | $108.99 | 1.53x | $77–$135 · P90 $200 | 13,297 | Benchmark |
| Washington | $101.86 | 1.43x | $75–$141 · P90 $198 | 22,961 | Benchmark |
| Iowa | $97.97 | 1.38x | $68–$218 · P90 $224 | 4,705 | Benchmark |
| Montana | $95.40 | 1.34x | $66–$143 · P90 $306 | 1,249 | Benchmark |
| District of Columbia | $93.77 | 1.32x | $71–$124 · P90 $169 | 3,274 | Benchmark |
| Colorado | $91.79 | 1.29x | $66–$191 · P90 $203 | 15,630 | Benchmark |
| Arkansas | $87.51 | 1.23x | $67–$106 · P90 $143 | 3,929 | Benchmark |
| Illinois | $86.28 | 1.21x | $65–$119 · P90 $177 | 36,984 | Benchmark |
| Pennsylvania | $86.18 | 1.21x | $71–$128 · P90 $172 | 43,916 | Benchmark |
| Idaho | $85.37 | 1.20x | $67–$110 · P90 $148 | 1,452 | Benchmark |
| Michigan | $85.11 | 1.20x | $69–$122 · P90 $144 | 23,049 | Benchmark |
| West Virginia | $84.78 | 1.19x | $66–$125 · P90 $151 | 6,750 | Benchmark |
| Rhode Island | $84.65 | 1.19x | $63–$111 · P90 $147 | 6,344 | Benchmark |
| Tennessee | $82.61 | 1.16x | $69–$132 · P90 $176 | 17,216 | Benchmark |
| Minnesota | $80.67 | 1.13x | $67–$140 · P90 $194 | 11,004 | Benchmark |
| Maryland | $80.01 | 1.12x | $67–$160 · P90 $174 | 20,070 | Benchmark |
| Hawaii | $80.00 | 1.12x | $69–$100 · P90 $150 | 1,120 | Benchmark |
| Maine | $78.36 | 1.10x | $60–$109 · P90 $138 | 12,917 | Benchmark |
| South Carolina | $78.07 | 1.10x | $66–$111 · P90 $137 | 20,993 | Benchmark |
| Florida | $77.69 | 1.09x | $63–$104 · P90 $151 | 37,100 | Benchmark |
| Delaware | $77.60 | 1.09x | $67–$98 · P90 $152 | 1,431 | Benchmark |
| Louisiana | $76.81 | 1.08x | $71–$101 · P90 $146 | 6,779 | Benchmark |
| California | $76.74 | 1.08x | $66–$130 · P90 $265 | 178,268 | Benchmark |
| New Mexico | $76.68 | 1.08x | $59–$99 · P90 $132 | 2,425 | Benchmark |
| Indiana | $76.22 | 1.07x | $65–$77 · P90 $107 | 62,196 | Benchmark |
| Alaska | $75.76 | 1.06x | $61–$109 · P90 $170 | 531 | Benchmark |
| New York | $75.36 | 1.06x | $63–$128 · P90 $196 | 271,595 | Benchmark |
| Arizona | $75.21 | 1.06x | $56–$102 · P90 $151 | 8,805 | Benchmark |
| Georgia | $75.07 | 1.05x | $56–$107 · P90 $148 | 104,913 | Benchmark |
| Texas | $74.93 | 1.05x | $58–$100 · P90 $156 | 51,632 | Benchmark |
| New Jersey | $74.90 | 1.05x | $58–$106 · P90 $169 | 30,940 | Benchmark |
| Wyoming | $74.71 | 1.05x | $66–$127 · P90 $186 | 978 | Benchmark |
| Vermont | $74.60 | 1.05x | $62–$109 · P90 $151 | 2,094 | Benchmark |
| Utah | $72.88 | 1.02x | $67–$102 · P90 $127 | 10,428 | Benchmark |
| Virginia | $71.71 | 1.01x | $56–$94 · P90 $132 | 44,181 | Benchmark |
| Oklahoma | $71.54 | 1.01x | $57–$95 · P90 $115 | 4,684 | Benchmark |
| Kansas | $70.37 | 0.99x | $58–$82 · P90 $109 | 5,082 | Benchmark |
| Ohio | $69.27 | 0.97x | $52–$99 · P90 $145 | 119,366 | Benchmark |
| Mississippi | $68.40 | 0.96x | $57–$93 · P90 $148 | 3,691 | Benchmark |
| Nevada | $68.17 | 0.96x | $68–$82 · P90 $123 | 5,135 | Benchmark |
| Missouri | $67.05 | 0.94x | $55–$92 · P90 $132 | 61,715 | Benchmark |
| Alabama | $66.99 | 0.94x | $58–$78 · P90 $109 | 5,526 | Benchmark |
| North Carolina | $66.22 | 0.93x | $66–$97 · P90 $149 | 122,607 | Benchmark |
| Kentucky | $58.60 | 0.82x | $46–$74 · P90 $106 | 26,865 | Benchmark |
Payer-blind local peer percentiles per state, full verified distribution. Publication floor: 11 verified rate points and a non-degenerate spread; the P25–P75 band unlocks at 25 points, P90 at 100 (a smaller cell's P90 is one contract, not a statistic).
Documented reimbursement figures are modeled, not guaranteed. Derived from federally mandated Transparency in Coverage data (45 CFR 147.212). No PHI.
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Cite this page
Source: Reddenda Code Reality Check, CPT 99202. Reddenda. https://reddenda.health/code/99202/
Derivation federally mandated TiC MRFs, verified to provider identity1,592,861 verified rate points across 51 statesas of 2026-07-15 · methodology v1.0