Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes
Medicare pricing data for 15,967 providers across 52 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes (HCPCS code 99347) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $42.84, but hospitals typically charge $103.23 — a 2.4x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $42.84, your out-of-pocket cost would be approximately $8.57. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.4x more than what Medicare allows for this procedure. Medicare actually pays $31.37 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $54 | $215 | 69 | 346 | +26.7% |
| New York | $49 | $110 | 1,009 | 72,889 | +13.5% |
| New Jersey | $46 | $100 | 686 | 28,754 | +8.2% |
| California | $45 | $108 | 1,125 | 56,393 | +5.7% |
| Puerto Rico | $45 | $73 | 62 | 1,432 | +4.2% |
| Illinois | $44 | $99 | 697 | 33,385 | +2.5% |
| New Mexico | $43 | $79 | 59 | 1,419 | +1.3% |
| District of Columbia | $43 | $104 | 35 | 741 | +1.2% |
| Massachusetts | $43 | $106 | 351 | 8,758 | +0.0% |
| Rhode Island | $43 | $121 | 50 | 854 | +0.0% |
| Michigan | $43 | $95 | 669 | 25,351 | -0.0% |
| Pennsylvania | $43 | $87 | 981 | 28,386 | -0.1% |
| Connecticut | $43 | $103 | 191 | 3,703 | -0.4% |
| Delaware | $43 | $140 | 45 | 1,292 | -0.5% |
| Maryland | $43 | $97 | 354 | 12,108 | -0.6% |
| Nevada | $43 | $118 | 103 | 2,215 | -0.7% |
| Washington | $42 | $128 | 291 | 6,053 | -0.8% |
| Oregon | $42 | $134 | 100 | 2,402 | -1.2% |
| Georgia | $42 | $95 | 256 | 7,403 | -2.1% |
| Virginia | $42 | $106 | 517 | 16,976 | -2.6% |
| Hawaii | $42 | $142 | 22 | 250 | -2.6% |
| Vermont | $42 | $124 | 28 | 253 | -2.6% |
| South Dakota | $42 | $79 | 29 | 730 | -2.7% |
| Florida | $42 | $109 | 1,445 | 86,378 | -2.8% |
| Oklahoma | $41 | $84 | 150 | 9,252 | -4.2% |
| Wisconsin | $41 | $95 | 264 | 7,463 | -4.5% |
| Ohio | $41 | $92 | 835 | 20,366 | -4.9% |
| Texas | $40 | $108 | 985 | 36,022 | -5.5% |
| New Hampshire | $40 | $115 | 93 | 2,587 | -5.9% |
| Montana | $40 | $129 | 50 | 556 | -6.0% |
| Minnesota | $40 | $114 | 327 | 5,295 | -6.2% |
| West Virginia | $40 | $107 | 58 | 561 | -6.8% |
| Arizona | $40 | $107 | 355 | 6,138 | -7.1% |
| Utah | $40 | $111 | 138 | 3,346 | -7.2% |
| South Carolina | $40 | $88 | 294 | 7,447 | -7.3% |
| Iowa | $40 | $116 | 159 | 2,506 | -7.6% |
| Alabama | $40 | $84 | 128 | 3,027 | -7.6% |
| Nebraska | $39 | $100 | 72 | 1,344 | -8.1% |
| Maine | $39 | $112 | 114 | 2,197 | -8.4% |
| Wyoming | $39 | $147 | 46 | 738 | -8.6% |
| Colorado | $39 | $116 | 337 | 8,640 | -9.4% |
| North Dakota | $39 | $120 | 38 | 210 | -9.6% |
| Indiana | $39 | $86 | 406 | 8,907 | -9.7% |
| Louisiana | $39 | $102 | 96 | 896 | -9.9% |
| Missouri | $39 | $92 | 276 | 8,834 | -10.0% |
| Kentucky | $38 | $100 | 199 | 4,052 | -10.6% |
| North Carolina | $38 | $91 | 552 | 16,074 | -11.0% |
| Tennessee | $38 | $99 | 317 | 6,591 | -11.6% |
| Arkansas | $38 | $98 | 62 | 1,048 | -11.8% |
| Kansas | $38 | $115 | 186 | 5,808 | -12.3% |
| Mississippi | $37 | $93 | 107 | 1,953 | -13.7% |
| Idaho | $37 | $111 | 113 | 1,094 | -14.4% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber