Medicare Physician Fee Schedule · Q3 2026 release
CPT 99204 in Miami, FL
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 Miami, FL
$193.00
Before the ~2% sequestration cut. Q3 2026 Physician Fee Schedule.
Local vs. national amount
Miami, FL pays above the national baseline by 8.8%, driven by this locality's GPCIs.
Facility setting
In a facility (e.g. hospital outpatient), Miami, FL pays $130.06 for 99204.
ZIP codes in this locality
This payment locality covers 145 ZIP codes, including 33001, 33002, 33010, 33011, 33012, 33013, 33014, 33015, 33016, 33017, 33018, 33030 and others . Every ZIP in this locality is priced the same under the Physician Fee Schedule.