Medicare Physician Fee Schedule · Q3 2026 release
CPT 99204 in San Diego, CA
A moderate-complexity visit for a new patient — for example, establishing care for someone with two or more chronic conditions, or evaluating a new problem such as unexplained weight loss that needs further work-up. Total visit time typically runs about 45 to 59 minutes, and documentation should reflect a more detailed history, moderate data review, and moderate risk from the plan of care.
Medicare pays, Office (non-facility) setting, in San Diego, CA
$192.46
Before the ~2% sequestration cut. Q3 2026 Physician Fee Schedule.
Local vs. national amount
San Diego, CA pays above the national baseline by 8.5%, driven by this locality's GPCIs.
Facility setting
In a facility (e.g. hospital outpatient), San Diego, CA pays $120.16 for 99204.
ZIP codes in this locality
This payment locality covers 190 ZIP codes, including 91901, 91902, 91903, 91905, 91906, 91908, 91909, 91910, 91911, 91912, 91913, 91914 and others . Every ZIP in this locality is priced the same under the Physician Fee Schedule.