How much does office visit, new patient, level 5 cost in Texas?

CPT 99205 — the fair price, every hospital's price, and the Medicare benchmark for Texas.

Estimates only. Educational estimates from public Medicare benchmarks and hospital-published prices — not a guarantee, and not legal, medical, or financial advice.
99205 Office visit, new patient, level 5
Ask to pay
$432
About 2.0× what Medicare pays — most hospitals accept a self-pay rate in this range.
What Medicare paysⓘ
$216
Typical price near you
$471
Cash / self-pay price
$491
Prices near you — 67 facilities, lowest first
FacilityTypePricevs MedicareQuality
University Medical Center of El Paso lowest ⚠ likely error Hospital $35cash 0.2× ★★★★★
CHRISTUS Santa Rosa Hospital – Westover Hills (San Antonio) ⚠ likely error Hospital $37cash 0.2× —
Memorial Hermann–Texas Medical Center (Houston) Hospital $54cash 0.3× ★★★★★
Memorial Hermann Memorial City Medical Center (Houston) Hospital $54cash 0.3× ★★★★★
Memorial Hermann The Woodlands Medical Center (The Woodlands) Hospital $54cash 0.3× —
Texas Health Harris Methodist Hospital Fort Worth Hospital $112cash 0.5× —
Texas Health Harris Methodist Hospital Southwest Fort Worth Hospital $112cash 0.5× —
Texas Health Harris Methodist Hospital Alliance (Fort Worth) Hospital $112cash 0.5× —
Texas Health Presbyterian Hospital Allen Hospital $112cash 0.5× —
Texas Health Presbyterian Hospital Denton Hospital $112cash 0.5× —
Texas Health Hospital Frisco Hospital $112cash 0.5× —
Texas Health Harris Methodist Hospital Stephenville Hospital $112cash 0.5× —
Prices from each hospital's public machine-readable file; imaging & surgery-center prices are published self-pay rates (often the cheapest option). vs Medicare is how many times the Medicare rate each facility charges. 6 unusually low/high prices excluded from the typical price as likely data errors.
💬 What to say — negotiation scripts
  • For 99205 (Office visit, new patient, level 5), Medicare's benchmark rate is $215.75. A fair self-pay target for this line is $431.50. If I was charged more than that, please reduce it toward this benchmark.
  • Your own published cash / self-pay price for 99205 is $491.00, and negotiated rates at nearby facilities run $122.00–$1,230.16. Please apply a rate in that range to my bill rather than the gross charge.
  • Please send a fully itemized bill listing every CPT/HCPCS/DRG code and its individual charge, so I can review each line against published rates.
  • Separately, what is your financial assistance / charity care policy, and am I eligible? Please send me the application and the income thresholds.
See office visit, new patient, level 5 prices in another area
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What should 99205 cost in Texas?

For office visit, new patient, level 5 (CPT 99205) in Texas, a fair self-pay price is around $471, with hospitals ranging from $122 to $1,230 across 67 facilities. Medicare's benchmark rate is $216, the floor to negotiate toward. The card above lists each hospital's price, cheapest first, with CMS quality stars.

Frequently asked questions

How much does office visit, new patient, level 5 cost in Texas?

A fair self-pay price for office visit, new patient, level 5 (CPT 99205) in Texas is around $471, with hospital prices ranging from $122 to $1,230 across 67 facilities. These are estimates from hospital-published prices, not a guarantee.

What is the Medicare rate for CPT 99205?

Medicare pays about $216 for office visit, new patient, level 5 (CPT 99205). That's the negotiation floor — a fair cash-pay target is roughly 1.5–2× it, well below typical gross charges.

Can I negotiate the price of office visit, new patient, level 5?

Yes. Under the federal Hospital Price Transparency rule hospitals must publish these rates, so you can ask to pay the cash or negotiated rate instead of the gross charge. Paste your bill on the home page for a ready-to-send appeal letter and the exact numbers to cite.

Got a bill for this?

If you were charged more than the fair price, you can usually negotiate it down. Paste your itemized bill to get a personalized appeal letter, the exact numbers to cite, an AI negotiation coach, and a charity-care eligibility check — free.

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Prices last refreshed September 2026 from each hospital's official CMS machine-readable file. Medicare rate: CY2025 OPPS/PFS/CLFS. Estimates only — not a guarantee.