How much does new patient office visit, moderate complexity cost in Michigan?
CPT 99204 — the fair price, every hospital's price, and the Medicare benchmark for Michigan.
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
$154
56 facilities · typical range $108 – $222 · 0.9× Medicare PFS
Typical
$154
Medicare $163
$82 lowboxed = typical rangehigh $2,833
What Medicare pays
$163
Market typical
$154
Cash / self-pay price
$155
Prices near you — 56 facilities, lowest first
| Facility | Type | Price | vs Medicare | Quality |
|---|---|---|---|---|
| DMC Huron Valley-Sinai Hospital (Commerce Township) lowest | Hospital | $82negotiated | 0.5× | ★★★★★ hip/knee complications 5% |
| University of Michigan Health University Hospital (Michigan Medicine, Ann Arbor) | Hospital | $90cash | 0.5× | ★★★★★ hip/knee complications 4.9% |
| McLaren Oakland (Pontiac) | Hospital | $96cash | 0.6× | ★★★★★ |
| McLaren Macomb (Mount Clemens) | Hospital | $96cash | 0.6× | ★★★★★ |
| McLaren Northern Michigan (Petoskey) | Hospital | $96cash | 0.6× | ★★★★★ hip/knee complications 4.3% |
| McLaren Port Huron | Hospital | $96cash | 0.6× | ★★★★★ hip/knee complications 4.7% |
| UP Health System - Marquette | Hospital | $97cash | 0.6× | ★★★★★ hip/knee complications 4.7% |
| DMC Harper University Hospital | Hospital | $99negotiated | 0.6× | ★★★★★ hip/knee complications 3.3% |
| McLaren Bay Region (Bay City) | Hospital | $101cash | 0.6× | ★★★★★ hip/knee complications 4.2% |
| McLaren Flint | Hospital | $102cash | 0.6× | ★★★★★ hip/knee complications 5.6% |
| 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% |
| Corewell Health Blodgett Hospital (East Grand Rapids; shares CCN with Butterworth) | Hospital | $108negotiated | 0.7× | ★★★★★ hip/knee complications 4.5% |
| Corewell Health Butterworth Hospital (Grand Rapids) | Hospital | $108negotiated | 0.7× | ★★★★★ hip/knee complications 4.5% |
| Trinity Health Livingston Hospital (Howell) | Hospital | $114negotiated | 0.7× | ★★★★★ hip/knee complications 3.5% |
| University of Michigan Health-Sparrow Lansing (Edward W. Sparrow Hospital) | Hospital | $116cash | 0.7× | ★★★★★ |
| Munson Medical Center (Traverse City) | Hospital | $116cash | 0.7× | ★★★★★ hip/knee complications 4.4% |
| 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% |
| McLaren Greater Lansing | Hospital | $124cash | 0.8× | ★★★★★ hip/knee complications 3.3% |
| Trinity Health Muskegon Hospital (former Mercy Health Hackley) | Hospital | $143negotiated | 0.9× | ★★★★★ hip/knee complications 4.4% |
| MyMichigan Medical Center Alpena | Hospital | $154cash | 0.9× | ★★★★★ hip/knee complications 4.1% |
| MyMichigan Medical Center Midland | Hospital | $154cash | 0.9× | ★★★★★ hip/knee complications 2.9% |
| MyMichigan Medical Center Saginaw (former St. Mary's of Michigan) | Hospital | $154cash | 0.9× | ★★★★★ hip/knee complications 4.7% |
| Henry Ford Providence Southfield Hospital (former Ascension Providence) | Hospital | $154cash | 0.9× | ★★★★★ hip/knee complications 4.8% |
| Henry Ford Genesys Hospital (Grand Blanc; former Ascension Genesys) | Hospital | $155cash | 1.0× | ★★★★★ hip/knee complications 4.3% |
| Trinity Health Grand Rapids Hospital (former Mercy Health Saint Mary's) | Hospital | $156negotiated | 1.0× | ★★★★★ hip/knee complications 3.4% |
| Henry Ford Jackson Hospital (former Allegiance Health) | Hospital | $160cash | 1.0× | ★★★★★ hip/knee complications 3.8% |
| Henry Ford Hospital (Detroit) | Hospital | $168cash | 1.0× | ★★★★★ |
| Henry Ford Macomb Hospital (Clinton Township) | Hospital | $168cash | 1.0× | ★★★★★ hip/knee complications 5.6% |
| Henry Ford West Bloomfield Hospital | Hospital | $168cash | 1.0× | ★★★★★ hip/knee complications 3.3% |
| Henry Ford Wyandotte Hospital | Hospital | $168cash | 1.0× | ★★★★★ |
| Chelsea Hospital (Trinity Health / Michigan Medicine) | Hospital | $176negotiated | 1.1× | ★★★★★ hip/knee complications 3.5% |
| Trinity Health Ann Arbor Hospital | Hospital | $176negotiated | 1.1× | ★★★★★ hip/knee complications 3.3% |
| Trinity Health Livonia Hospital | Hospital | $176negotiated | 1.1× | ★★★★★ hip/knee complications 4.6% |
| Henry Ford Rochester Hospital (former Ascension Providence Rochester) | Hospital | $183cash | 1.1× | ★★★★★ hip/knee complications 3.6% |
| University of Michigan Health-West (Wyoming) | Hospital | $184cash | 1.1× | ★★★★★ hip/knee complications 4.3% |
| Holland Hospital | Hospital | $189cash | 1.2× | ★★★★★ |
| Corewell Health Dearborn Hospital | Hospital | $215negotiated | 1.3× | ★★★★★ hip/knee complications 4.6% |
| Corewell Health Farmington Hills Hospital | Hospital | $215negotiated | 1.3× | ★★★★★ hip/knee complications 4% |
| Corewell Health Lakeland Hospital (St. Joseph) | Hospital | $224negotiated | 1.4× | ★★★★★ hip/knee complications 3.4% |
| Corewell Health Beaumont Troy Hospital | Hospital | $240negotiated | 1.5× | ★★★★★ hip/knee complications 4.1% |
| Corewell Health William Beaumont University Hospital (Royal Oak) | Hospital | $240negotiated | 1.5× | ★★★★★ hip/knee complications 4.1% |
| Corewell Health Beaumont Grosse Pointe Hospital | Hospital | $241negotiated | 1.5× | ★★★★★ hip/knee complications 3.7% |
| Covenant HealthCare (Saginaw) | Hospital | $247cash | 1.5× | ★★★★★ hip/knee complications 4.5% |
| Forest Health Medical Center (Ypsilanti) [PHYSICIAN-OWNED SPECIALTY SURGICAL HOSPITAL] | Hospital | $256cash | 1.6× | — |
| Surgeons Choice Medical Center (Southfield) [PHYSICIAN-OWNED SURGICAL HOSPITAL] | Hospital | $275cash | 1.7× | — |
| Beacon Kalamazoo (former Ascension Borgess Medical Center) | Hospital | $311negotiated | 1.9× | ★★★★★ hip/knee complications 3.8% |
| DMC Detroit Receiving Hospital | Hospital | $379cash | 2.3× | ★★★★★ |
| Bronson Battle Creek Hospital gross charge | Hospital | $700cash | 4.3× | ★★★★★ hip/knee complications 4.2% |
| Bronson Methodist Hospital (Kalamazoo) gross charge | Hospital | $700cash | 4.3× | ★★★★★ hip/knee complications 4.4% |
| DMC Sinai-Grace Hospital gross charge | Hospital | $757cash | 4.6× | ★★★★★ |
| Hurley Medical Center (Flint) gross charge | Hospital | $816cash | 5.0× | ★★★★★ |
| Henry Ford Providence Novi Hospital (former Ascension Providence; shares CCN with Southfield) gross charge | Hospital | $2,833negotiated | 17.3× | ★★★★★ hip/knee complications 4.8% |
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. 5 unusually low/high prices excluded from the typical price as likely data errors.
See new patient office visit, moderate complexity prices in another area
What should 99204 cost in Michigan?
For new patient office visit, moderate complexity (CPT 99204) in Michigan, a fair self-pay price is around $154, with hospitals ranging from $108 to $222 across 56 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 Michigan?
A fair self-pay price for new patient office visit, moderate complexity (CPT 99204) in Michigan is around $154, with hospital prices ranging from $108 to $222 across 56 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.
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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.