How much does new patient office visit, moderate complexity cost in detroit?

CPT 99204 — the fair price, every hospital's price, and the Medicare benchmark for detroit.

Estimates only. Educational estimates from public Medicare benchmarks and hospital-published prices — not a guarantee, and not legal, medical, or financial advice.
99204 New patient office visit, moderate complexity
Market typical price
$161
28 facilities · typical range $105 – $234 · 1.0× Medicare PFS
What Medicare pays
$163
Market typical
$161
Cash / self-pay price
$168
Prices near you — 28 facilities, lowest first
FacilityTypePricevs MedicareQuality
DMC Huron Valley-Sinai Hospital (Commerce Township) lowest Hospital $82negotiated 0.5× ★★★★★
hip/knee complications 5%
McLaren Oakland (Pontiac) Hospital $96cash 0.6× ★★★★★
McLaren Macomb (Mount Clemens) Hospital $96cash 0.6× ★★★★★
McLaren Port Huron Hospital $96cash 0.6× ★★★★★
hip/knee complications 4.7%
DMC Harper University Hospital Hospital $99negotiated 0.6× ★★★★★
hip/knee complications 3.3%
Corewell Health Taylor Hospital Hospital $105negotiated 0.6× ★★★★★
hip/knee complications 3.7%
Corewell Health Trenton Hospital Hospital $105negotiated 0.6× ★★★★★
Corewell Health Wayne Hospital Hospital $105negotiated 0.6× ★★★★★
Trinity Health Oakland Hospital (Pontiac) Hospital $108negotiated 0.7× ★★★★★
hip/knee complications 6.7%
Trinity Health Livingston Hospital (Howell) Hospital $114negotiated 0.7× ★★★★★
hip/knee complications 3.5%
Henry Ford St. John Hospital (Detroit; former Ascension St. John) Hospital $118cash 0.7× ★★★★★
hip/knee complications 3.8%
Henry Ford Warren Hospital (former Ascension Macomb-Oakland) Hospital $118cash 0.7× ★★★★★
hip/knee complications 3.5%
Prices from each hospital's public machine-readable file; imaging & surgery-center prices are published self-pay rates (often the cheapest option). vs Medicare is how many times the Medicare rate each facility charges. 2 unusually low/high prices excluded from the typical price as likely data errors.
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What should 99204 cost in detroit?

For new patient office visit, moderate complexity (CPT 99204) in detroit, a fair self-pay price is around $161, with hospitals ranging from $105 to $234 across 28 facilities. Medicare's benchmark rate is $163, the benchmark every published rate is measured against. The card above lists each hospital's price, cheapest first, with CMS quality stars.

Frequently asked questions

How much does new patient office visit, moderate complexity cost in detroit?

A fair self-pay price for new patient office visit, moderate complexity (CPT 99204) in detroit is around $161, with hospital prices ranging from $105 to $234 across 28 facilities. These are estimates from hospital-published prices, not a guarantee.

What is the Medicare rate for CPT 99204?

Medicare pays about $163 for new patient office visit, moderate complexity (CPT 99204). That's the negotiation floor — a fair cash-pay target is roughly 1.5–2× it, well below typical gross charges.

Can I negotiate the price of new patient office visit, moderate complexity?

Yes. Under the federal Hospital Price Transparency rule hospitals must publish these rates, so you can ask to pay the cash or negotiated rate instead of the gross charge. Paste your bill on the home page for a ready-to-send appeal letter and the exact numbers to cite.

Placing a referral for this?

Enter the patient's ZIP and plan in the facility finder to see every facility near them that publishes a price for 99204, ranked, with the phone number and an out-of-pocket estimate.

Compare other procedures in detroit

Total knee replacement (arthroplasty)Total hip replacement (arthroplasty)Partial (unicompartmental) knee replacementTotal shoulder replacement (arthroplasty)Revision total knee replacementRevision total hip replacementMajor hip/knee joint replacement, inpatient, w/o MCCMajor hip/knee joint replacement, inpatient, w/ MCC

Prices last refreshed September 2026 from each hospital's official CMS machine-readable file. Medicare rate: CY2025 OPPS/PFS/CLFS. Estimates only — not a guarantee.