Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Top Providers in Georgia
| Provider | Medicare | Services |
|---|---|---|
| Parent, Thomas MD | $114.94 | 596 |
Georgia Pricing in Context
In Georgia, CPT code 99204 (New Patient Office Or Other Outpatient Visit, 45-59 Minutes) carries an average Medicare payment of $108.24 — 3% below the national benchmark of $111.40. 15.6K providers across the state submitted claims for this procedure in 2023, performing 370.4K total services. Individual payments in GA ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.
The average billed charge in Georgia is $410.72, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Georgia sits below the national Medicare average, commercial rates in the state may also run lower than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Office Visit procedures, the estimated commercial insurance price in Georgia lands near $346.43, with self-pay cash prices typically around $228.42. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.
Frequently Asked Questions
How much does New Patient Office Or Other Outpatient Visit, 45-59 Minutes cost in Georgia?
The average Medicare payment for New Patient Office Or Other Outpatient Visit, 45-59 Minutes in Georgia is $108.24, which is 3% below the national average of $111.40. Providers in GA typically bill $410.72 for this procedure.
What does New Patient Office Or Other Outpatient Visit, 45-59 Minutes cost with insurance in Georgia?
With commercial insurance in Georgia, New Patient Office Or Other Outpatient Visit, 45-59 Minutes costs an estimated $346.43. Without insurance, the estimated cash price is $228.42. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform New Patient Office Or Other Outpatient Visit, 45-59 Minutes in Georgia?
15.6K providers in Georgia billed Medicare for New Patient Office Or Other Outpatient Visit, 45-59 Minutes in 2023, performing 370.4K total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is New Patient Office Or Other Outpatient Visit, 45-59 Minutes cheaper in Georgia than the national average?
Yes — New Patient Office Or Other Outpatient Visit, 45-59 Minutes costs 3% below the national average in Georgia. The state average Medicare payment is $108.24 compared to $111.40 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.