Code Reality Check
99203 reimbursement rate: Office visit, new patient, 30-44 min
Office visit, new patient, 30-44 min (CPT 99203) pays a median $185.43 in Wisconsin and $83.63 in Kentucky, against a Medicare anchor of $110.30. 51 of 51 states clear the publication floor.
spread 2.2x top to bottom
Medicare anchor $110.30
51/51 states published
The 50-state spread
as of 2026-07-15| State | Median | vs Medicare | Band | Rate points | Tier |
|---|---|---|---|---|---|
| Wisconsin | $185.43 | 1.68x | $106–$240 · P90 $286 | 39,006 | Benchmark |
| New Hampshire | $170.05 | 1.54x | $126–$176 · P90 $268 | 10,650 | Benchmark |
| District of Columbia | $144.83 | 1.31x | $108–$145 · P90 $210 | 1,911 | Benchmark |
| Minnesota | $142.37 | 1.29x | $104–$177 · P90 $250 | 8,462 | Benchmark |
| Colorado | $137.59 | 1.25x | $104–$211 · P90 $211 | 9,197 | Benchmark |
| Washington | $133.41 | 1.21x | $96–$192 · P90 $279 | 10,698 | Benchmark |
| Virginia | $129.30 | 1.17x | $109–$145 · P90 $188 | 30,969 | Benchmark |
| Massachusetts | $124.73 | 1.13x | $95–$170 · P90 $244 | 7,483 | Benchmark |
| Maryland | $123.13 | 1.12x | $88–$145 · P90 $201 | 5,363 | Benchmark |
| Delaware | $117.98 | 1.07x | $97–$142 · P90 $204 | 984 | Benchmark |
| Maine | $116.18 | 1.05x | $95–$170 · P90 $213 | 10,438 | Benchmark |
| Pennsylvania | $112.56 | 1.02x | $97–$126 · P90 $167 | 30,646 | Benchmark |
| Oregon | $112.40 | 1.02x | $86–$172 · P90 $277 | 2,070 | Benchmark |
| Montana | $111.99 | 1.02x | $89–$172 · P90 $265 | 529 | Benchmark |
| South Carolina | $111.75 | 1.01x | $86–$134 · P90 $172 | 6,912 | Benchmark |
| Iowa | $111.54 | 1.01x | $97–$149 · P90 $222 | 1,453 | Benchmark |
| Indiana | $110.44 | 1.00x | $96–$119 · P90 $148 | 54,848 | Benchmark |
| Michigan | $110.44 | 1.00x | $88–$154 · P90 $220 | 6,653 | Benchmark |
| Utah | $110.44 | 1.00x | $86–$170 · P90 $255 | 1,115 | Benchmark |
| North Dakota | $110.39 | 1.00x | $86–$155 · P90 $211 | 356 | Benchmark |
| Hawaii | $110.21 | 1.00x | $86–$144 · P90 $226 | 939 | Benchmark |
| Idaho | $110.20 | 1.00x | $86–$149 · P90 $218 | 746 | Benchmark |
| California | $110.02 | 1.00x | $99–$239 · P90 $399 | 137,525 | Benchmark |
| New Mexico | $109.23 | 0.99x | $86–$154 · P90 $226 | 1,063 | Benchmark |
| Nebraska | $109.00 | 0.99x | $83–$160 · P90 $216 | 610 | Benchmark |
| Alaska | $108.94 | 0.99x | $86–$156 · P90 $217 | 407 | Benchmark |
| Arizona | $108.94 | 0.99x | $85–$148 · P90 $234 | 3,861 | Benchmark |
| Nevada | $108.94 | 0.99x | $86–$147 · P90 $270 | 1,704 | Benchmark |
| Oklahoma | $108.94 | 0.99x | $87–$144 · P90 $205 | 1,246 | Benchmark |
| Louisiana | $108.60 | 0.98x | $84–$147 · P90 $226 | 1,529 | Benchmark |
| Mississippi | $107.65 | 0.98x | $86–$135 · P90 $210 | 738 | Benchmark |
| Ohio | $107.04 | 0.97x | $79–$169 · P90 $226 | 88,803 | Benchmark |
| South Dakota | $106.68 | 0.97x | $84–$170 · P90 $226 | 287 | Benchmark |
| Illinois | $106.60 | 0.97x | $85–$141 · P90 $227 | 13,873 | Benchmark |
| Georgia | $106.39 | 0.96x | $84–$156 · P90 $219 | 95,730 | Benchmark |
| New Jersey | $106.02 | 0.96x | $76–$173 · P90 $226 | 19,485 | Benchmark |
| Texas | $105.77 | 0.96x | $82–$144 · P90 $218 | 30,579 | Benchmark |
| Arkansas | $105.22 | 0.95x | $84–$144 · P90 $190 | 1,230 | Benchmark |
| Florida | $104.80 | 0.95x | $82–$134 · P90 $207 | 17,802 | Benchmark |
| Alabama | $104.68 | 0.95x | $82–$130 · P90 $196 | 2,701 | Benchmark |
| Tennessee | $104.49 | 0.95x | $83–$133 · P90 $183 | 7,468 | Benchmark |
| Vermont | $103.04 | 0.93x | P75 $170 · P90 $213 | 1,418 | Benchmark |
| Wyoming | $102.39 | 0.93x | $86–$152 · P90 $197 | 626 | Benchmark |
| Missouri | $99.91 | 0.91x | $81–$119 · P90 $163 | 53,579 | Benchmark |
| Kansas | $99.91 | 0.91x | $81–$134 · P90 $179 | 1,792 | Benchmark |
| Connecticut | $97.41 | 0.88x | $77–$161 · P90 $277 | 4,641 | Benchmark |
| New York | $97.33 | 0.88x | P75 $135 · P90 $279 | 235,150 | Benchmark |
| Rhode Island | $95.14 | 0.86x | $91–$131 · P90 $204 | 4,902 | Benchmark |
| West Virginia | $93.20 | 0.84x | $79–$126 · P90 $148 | 2,231 | Benchmark |
| North Carolina | $86.00 | 0.78x | $86–$119 · P90 $197 | 99,056 | Benchmark |
| Kentucky | $83.63 | 0.76x | $65–$107 · P90 $143 | 35,205 | 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.
One code is a data point. Your contract is the story.
The spread above is payer-blind. Where your own contracts sit inside it, payer by payer and code by code, is what the Mirror shows for any NPI, free, in seconds.
Cite this page
Source: Reddenda Code Reality Check, CPT 99203. Reddenda. https://reddenda.health/code/99203/
Derivation federally mandated TiC MRFs, verified to provider identity1,106,669 verified rate points across 51 statesas of 2026-07-15 · methodology v1.0