Medicare Physician Fee Schedule · Q3 2026 release
CPT 99213 in Queens, 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 Queens, NY
$108.18
Before the ~2% sequestration cut. Q3 2026 Physician Fee Schedule.
Local vs. national amount
Queens, NY pays above the national baseline by 13.6%, driven by this locality's GPCIs.
Facility setting
In a facility (e.g. hospital outpatient), Queens, NY pays $63.56 for 99213.
ZIP codes in this locality
This payment locality covers 84 ZIP codes, including 11004, 11005, 11101, 11102, 11103, 11104, 11105, 11106, 11109, 11120, 11351, 11352 and others . Every ZIP in this locality is priced the same under the Physician Fee Schedule.