Medicare Physician Fee Schedule · Q3 2026 release
CPT 99213 in Long Island, NY
A routine established-patient visit for a problem of low-to-moderate complexity — for example, checking in on one or two stable chronic conditions like well-controlled hypertension or diabetes, or evaluating a new minor issue such as a cough or ankle sprain. Total visit time typically runs about 20 to 29 minutes, and documentation should show the problem(s) addressed, any data reviewed (such as a lab result), and a low risk of complications from the plan of care. It is one of the most frequently billed services in all of medicine.
Medicare pays, Office (non-facility) setting, in Long Island, NY
$109.76
Before the ~2% sequestration cut. Q3 2026 Physician Fee Schedule.
Local vs. national amount
Long Island, NY pays above the national baseline by 15.3%, driven by this locality's GPCIs.
Facility setting
In a facility (e.g. hospital outpatient), Long Island, NY pays $64.89 for 99213.
ZIP codes in this locality
This payment locality covers 440 ZIP codes, including 00501, 00544, 06390, 10301, 10302, 10303, 10304, 10305, 10306, 10307, 10308, 10309 and others . Every ZIP in this locality is priced the same under the Physician Fee Schedule.