How much does new patient office visit, moderate complexity cost in Ohio?
CPT 99204 — the fair price, every hospital's price, and the Medicare benchmark for Ohio.
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
$170
63 facilities · typical range $113 – $289 · 1.0× Medicare PFS
Typical
$170
Medicare $163
$85 lowboxed = typical rangehigh $541
What Medicare paysⓘ
$163
Market typical
$170
Cash / self-pay price
$191
Prices near you — 63 facilities, lowest first
| Facility | Type | Price | vs Medicare | Quality |
|---|---|---|---|---|
| Metrohealth System (Cleveland) lowest | Hospital | $85cash | 0.5× | ★★★★★ hip/knee complications 4.7% |
| Fairfield Medical Center (Lancaster) | Hospital | $86cash | 0.5× | ★★★★★ hip/knee complications 4.6% |
| Coshocton Regional Medical Center (Coshocton) | Hospital | $91negotiated | 0.6× | ★★★★★ |
| East Liverpool City Hospital (East Liverpool) | Hospital | $92negotiated | 0.6× | ★★★★★ |
| Mercy Health - Tiffin Hospital (Tiffin) | Hospital | $97cash | 0.6× | ★★★★★ |
| Akron General Medical Center (Akron) | Hospital | $113cash | 0.7× | ★★★★★ hip/knee complications 4.6% |
| Cleveland Clinic (Cleveland) | Hospital | $113cash | 0.7× | ★★★★★ hip/knee complications 3.6% |
| Cleveland Clinic Avon Hospital (Avon) | Hospital | $113cash | 0.7× | ★★★★★ hip/knee complications 5.5% |
| Euclid Hospital (Euclid) | Hospital | $113cash | 0.7× | ★★★★★ |
| Fairview Hospital (Cleveland) | Hospital | $113cash | 0.7× | ★★★★★ |
| Hillcrest Hospital (Mayfield Heights) | Hospital | $113cash | 0.7× | ★★★★★ hip/knee complications 3.0% |
| Lutheran Hospital (Cleveland) | Hospital | $113cash | 0.7× | ★★★★★ hip/knee complications 3.9% |
| Marymount Hospital (Garfield Heights) | Hospital | $113cash | 0.7× | ★★★★★ hip/knee complications 3.4% |
| Medina Hospital (Medina) | Hospital | $113cash | 0.7× | ★★★★★ hip/knee complications 3.8% |
| South Pointe Hospital (Warrensville Heights) | Hospital | $113cash | 0.7× | ★★★★★ |
| Union Hospital (Dover) | Hospital | $113cash | 0.7× | ★★★★★ |
| Adena Regional Medical Center (Chillicothe) | Hospital | $115cash | 0.7× | ★★★★★ hip/knee complications 3.5% |
| Avita Ontario (Ontario) | Hospital | $119cash | 0.7× | ★★★★★ |
| Blanchard Valley Hospital (Findlay) | Hospital | $120cash | 0.7× | ★★★★★ hip/knee complications 7.2% |
| Mercy Health - Defiance Hospital (Defiance) | Hospital | $121cash | 0.7× | ★★★★★ |
| University Of Toledo Medical Center (Toledo) | Hospital | $125negotiated | 0.8× | ★★★★★ hip/knee complications 5.0% |
| Glenbeigh Health Sources (Rock Creek) | Hospital | $130negotiated | 0.8× | — |
| Mary Rutan Hospital (Bellefontaine) | Hospital | $163cash | 1.0× | ★★★★★ |
| Ohio State University State Health System (Columbus) | Hospital | $164negotiated | 1.0× | ★★★★★ hip/knee complications 3.9% |
| Kings Daughters Medical Center Ohio (Portsmouth) | Hospital | $168cash | 1.0× | — |
| Lake Health (Concord) | Hospital | $170negotiated | 1.0× | ★★★★★ hip/knee complications 5.8% |
| Lake Health Beachwood Medical Center (Beachwood) | Hospital | $170negotiated | 1.0× | hip/knee complications 4.0% |
| Parma Community General Hospital (Parma) | Hospital | $170negotiated | 1.0× | ★★★★★ |
| Uh Regional Hospitals (Chardon) | Hospital | $170negotiated | 1.0× | ★★★★★ |
| University Hospitals - Elyria Medical Center (Elyria) | Hospital | $170negotiated | 1.0× | ★★★★★ hip/knee complications 4.7% |
| University Hospitals Ahuja Medical Center (Beachwood) | Hospital | $170negotiated | 1.0× | ★★★★★ hip/knee complications 5.8% |
| University Hospitals Portage Medical Center (Ravenna) | Hospital | $170negotiated | 1.0× | ★★★★★ |
| Knox Community Hospital (Mount Vernon) | Hospital | $179cash | 1.1× | ★★★★★ |
| Wood County Hospital (Bowling Green) | Hospital | $182cash | 1.1× | ★★★★★ hip/knee complications 4.5% |
| Alliance Community Hospital (Alliance) | Hospital | $188negotiated | 1.2× | ★★★★★ hip/knee complications 4.3% |
| Crystal Clinic Orthopaedic Center (Akron) | Hospital | $191cash | 1.2× | ★★★★★ hip/knee complications 3.6% |
| Memorial Hospital (Marysville) | Hospital | $195cash | 1.2× | ★★★★★ |
| Mercer County Joint Township Community Hospital (Coldwater) | Hospital | $204cash | 1.3× | ★★★★★ |
| Marietta Memorial Hospital (Marietta) | Hospital | $205cash | 1.3× | ★★★★★ |
| Grand Lake Health System (Saint Marys) | Hospital | $213cash | 1.3× | ★★★★★ |
| Wilson Memorial Hospital (Sidney) | Hospital | $226cash | 1.4× | ★★★★★ |
| Genesis Hospital (Zanesville) | Hospital | $227cash | 1.4× | ★★★★★ hip/knee complications 4.9% |
| Ashtabula County Medical Center (Ashtabula) | Hospital | $238cash | 1.5× | ★★★★★ hip/knee complications 4.5% |
| Berger Hospital (Circleville) | Hospital | $277negotiated | 1.7× | ★★★★★ |
| Bethesda North (Cincinnati) | Hospital | $289negotiated | 1.8× | ★★★★★ hip/knee complications 4.4% |
| Good Samaritan Hospital (Cincinnati) | Hospital | $289negotiated | 1.8× | ★★★★★ hip/knee complications 4.1% |
| Mccullough-Hyde Memorial Hospital (Oxford) | Hospital | $289negotiated | 1.8× | ★★★★★ |
| Trihealth Clinton Regional Hospital (Wilmington) | Hospital | $289negotiated | 1.8× | ★★★★★ |
| Aultman Hospital (Canton) | Hospital | $296cash | 1.8× | ★★★★★ |
| Insight Hospital And Medical Center Trumbull (Warren) | Hospital | $300cash | 1.8× | ★★★★★ |
| Mount Carmel Dublin (Dublin) | Hospital | $302cash | 1.8× | — |
| Uh Cleveland Medical Center (Cleveland) | Hospital | $309cash | 1.9× | ★★★★★ |
| Pomerene Hospital (Millersburg) | Hospital | $325cash | 2.0× | ★★★★★ |
| Fisher-Titus Hospital (Norwalk) | Hospital | $325cash | 2.0× | ★★★★★ |
| Summa Health System (Akron) | Hospital | $329cash | 2.0× | ★★★★★ hip/knee complications 3.5% |
| Summa Western Reserve Hospital (Cuyahoga Falls) | Hospital | $329cash | 2.0× | ★★★★★ |
| Salem Regional Medical Center (Salem) | Hospital | $351cash | 2.2× | ★★★★★ |
| Mount Carmel East & West (Columbus) | Hospital | $366cash | 2.2× | ★★★★★ hip/knee complications 4.2% |
| Mount Carmel St Ann'S (Westerville) | Hospital | $370cash | 2.3× | ★★★★★ hip/knee complications 4.6% |
| Lima Memorial Health System (Lima) | Hospital | $399cash | 2.4× | ★★★★★ |
| Atrium Medical Center (Franklin) | Hospital | $541cash | 3.3× | ★★★★★ |
| Miami Valley Hospital (Dayton) | Hospital | $541cash | 3.3× | ★★★★★ hip/knee complications 3.0% |
| Upper Valley Medical Center (Troy) | Hospital | $541cash | 3.3× | ★★★★★ |
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.
See new patient office visit, moderate complexity prices in another area
What should 99204 cost in Ohio?
For new patient office visit, moderate complexity (CPT 99204) in Ohio, a fair self-pay price is around $170, with hospitals ranging from $113 to $289 across 63 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 Ohio?
A fair self-pay price for new patient office visit, moderate complexity (CPT 99204) in Ohio is around $170, with hospital prices ranging from $113 to $289 across 63 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 Ohio
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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.