Medicare Physician Fee Schedule · Q3 2026 release
CPT 99215 in Suburban Chicago, IL
The most complex established-patient office visit — for example, a severe flare of a chronic illness, or a new problem that threatens life or bodily function and requires a high-risk management decision such as a major medication change or weighing hospitalization. Total visit time typically runs about 40 to 54 minutes, and documentation must support high complexity in the problems addressed, the data reviewed, and the risk of the management plan. It is the highest-level established-patient office visit.
Medicare pays, Office (non-facility) setting, in Suburban Chicago, IL
$200.94
Before the ~2% sequestration cut. Q3 2026 Physician Fee Schedule.
Local vs. national amount
Suburban Chicago, IL pays above the national baseline by 4.4%, driven by this locality's GPCIs.
Facility setting
In a facility (e.g. hospital outpatient), Suburban Chicago, IL pays $132.33 for 99215.
ZIP codes in this locality
This payment locality covers 155 ZIP codes, including 60002, 60010, 60011, 60015, 60020, 60030, 60031, 60035, 60037, 60040, 60041, 60042 and others . Every ZIP in this locality is priced the same under the Physician Fee Schedule.