What does Bcbs Nc pay for CPT 99203 in Charlotte-Concord-Gastonia, NC-SC?

The local peer median for CPT 99203 under Bcbs Nc in Charlotte-Concord-Gastonia, NC-SC is $131, based on 1355 indexed providers. Modeled from published rates, not guaranteed.

What is the top of the local market (P90) for CPT 99203 under Bcbs Nc in Charlotte-Concord-Gastonia, NC-SC?

The P90, the top of the local market and Reddenda's target rate, is $204.40.

How does Bcbs Nc's rate for CPT 99203 compare to Medicare?

The Bcbs Nc local median of $131 is 111% of Medicare's national non-facility rate of $117.57 for CPT 99203.

Reddenda · Rate Intelligence · Charlotte-Concord-Gastonia, NC-SC

99203 under Bcbs Nc in Charlotte-Concord-Gastonia, NC-SC

Name: Bcbs Nc rates for CPT 99203 in Charlotte-Concord-Gastonia, NC-SC
Creator: Reddenda

Office visit, new patient, 30-44 min · Local peer median $131 · High confidence

$131 local peer median. In the Charlotte-Concord-Gastonia, NC-SC market, Bcbs Nc pays a local peer median of $131 for CPT 99203 (Office visit, new patient, 30-44 min), based on 1355 providers in Reddenda's index of Bcbs Nc's own published in-network rates. The top of the local market, the P90 target, is $204.40, 56% above the median. A provider billed below the local median is being paid less than peers holding the identical Bcbs Nc contract in Charlotte-Concord-Gastonia, NC-SC for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 1355 providers · 1355 rate records

P10

$48.75

P25

$101.43

Median

$131

P75

$177.88

P90 (target)

$204.40

P10$48.75

P25$101.43

Median (P50)$131

P75$177.88

P90 target$204.40

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $48.75 – $279.60

The local peer median for CPT 99203 under Bcbs Nc in Charlotte-Concord-Gastonia, NC-SC is $131, drawn from 1355 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Nc to publish this rate
The bottom of the local market (P10) is $48.75 and the top (P90) is $204.40; the median-to-P90 spread is $73.40.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Nc to publish this rate
The lowest published rate in this market is $48.75; the highest is $279.60.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Nc to publish this rate
This benchmark is drawn from 1355 individual rate records that Bcbs Nc itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Nc to publish this rate
Medicare's national non-facility rate for CPT 99203 is $117.57, making the Bcbs Nc local median 111% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Nc to publish this rate
11.1% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Nc to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

1355 providers bill this code to this payer in this metro.

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This is the local market for CPT 99203 (Office visit, new patient, 30-44 min) under Bcbs Nc in Charlotte-Concord-Gastonia, NC-SC. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

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Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Bcbs Nc's own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Nc to publish this rate. Page generated 2026-08-24 00:19 UTC; the live index is queried in real time on every request.