Average Medicaid Office Visit Payments in Sussex, WI: $36.25
Avg. Paid
$36.25
Range
$0.00 – $48.93
Total Claims
21,023
Providers
17
Typical Payment Range
Typical Medicaid Office Visit payments fall between $29.28 and $67.92 per claim (median: $46.55). The top 10% of payments exceed $95.29.
Based on per-provider averages across all Medicaid claims in this category.
A standard doctor's office visit for evaluation and management of medical conditions. Includes new patient visits, follow-up visits, and consultations.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Office Visit in Sussex, WI
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Jose S Abad Santos
W227N6103 Sussex Rd |
$36.39 | 11,932 | 11,121 |
|
Jennifer Donna Ouweneel
W227N6103 Sussex Rd |
$40.66 | 1,780 | 1,581 |
|
Joanne M Peterson
N66W25201 County Highway Vv |
$32.19 | 1,584 | 1,448 |
|
Ann J Shallue
N57W24950 N Corporate Cir |
$28.83 | 1,530 | 1,390 |
|
Thomas Steigerwald
N63W23231 Main St Unit 100 |
$48.70 | 1,172 | 1,057 |
|
Andrea Marie Cantwell-Durand
N51W24953 Lisbon Road |
$29.83 | 693 | 596 |
|
Christopher Michael Peters
N57W24950 N Corporate Cir |
$36.53 | 692 | 623 |
|
Kelly Woppert
N66W25201 County Highway Vv |
$29.92 | 348 | 275 |
|
Kevin Ciriacks
N57W24950 N Corporate Cir |
$48.93 | 308 | 295 |
|
Frances Barbara Schanz
N69W23301 Salem Ct E |
$45.23 | 267 | 236 |
|
Donald J. Daley
W227N6103 Sussex Rd |
$18.01 | 205 | 170 |
|
Camillia C Pignotti
Fastcare Clinic At Sussex Meijer |
$26.19 | 163 | 152 |
|
Stephen E. Morgan
N57W24950 N Corporate Cir |
$38.35 | 135 | 129 |
|
Samantha Sippl
N64W25037 Prospect Cir |
$36.54 | 79 | 66 |
|
Arthy Baskaran
N57W24950 N Corporate Cir |
$38.28 | 72 | 68 |
|
Hilary Anne Hetzel
N63W23231 Main St |
$22.85 | 49 | 39 |
|
Gurwinder Kaur
N51W24953 Lisbon Road |
$0.00 | 14 | 13 |
What to Expect: Office Visit
A typical office visit lasts 15-45 minutes depending on complexity. Your doctor will review your medical history, discuss symptoms, perform a physical exam, and discuss treatment options. You may receive prescriptions, referrals, or orders for diagnostic tests. Follow-up visits are usually shorter than new patient visits.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 99213 | Office visit established mod | $43.18 | 764,306,590 | 487,602 |
| 99214 | Office visit established mod-hi | $59.53 | 502,480,931 | 466,856 |
| 99212 | Office visit established low | $41.69 | 92,299,154 | 127,462 |
| 99203 | Office visit new moderate | $67.55 | 47,756,882 | 127,334 |
| 99211 | Office visit established minor | $39.24 | 44,127,221 | 47,748 |
| 99204 | Office visit new moderate-high | $92.03 | 32,379,031 | 111,937 |
| 99215 | Office visit established high | $93.58 | 29,619,773 | 74,725 |
| 99202 | Office visit new low | $58.57 | 9,372,712 | 35,486 |
| 99205 | Office visit new high | $136.10 | 3,665,382 | 19,737 |
| 99244 | Office consultation mod-high | $118.25 | 3,405,681 | 11,884 |
| 99243 | Office consultation moderate | $78.55 | 2,585,480 | 8,432 |
| 99245 | Office consultation high | $132.29 | 645,300 | 3,046 |
| 99242 | Office consultation low | $58.27 | 483,445 | 1,980 |
| 99241 | Office consultation brief | $66.15 | 295,664 | 712 |
These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Office Visit cost in Sussex, WI?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Sussex, WI is $36.25 per claim, based on 21,023 claims from 17 providers. Typical payments fall between $29.28 and $67.92. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Office Visit in Sussex, WI?
There are 17 Medicaid providers offering Office Visit related services in Sussex, WI according to public payment data.
What is the price range for Office Visit in Sussex, WI?
Medicaid reimbursement for Office Visit in Sussex, WI ranges from $0.00 to $48.93 per claim, with an average of $36.25. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Office Visit in Other Cities
Brooklyn, NY
Avg $71.20
32,336,840 claims · 5588 providers
New York, NY
Avg $81.86
23,551,154 claims · 7530 providers
Los Angeles, CA
Avg $24.20
16,948,065 claims · 5565 providers
Chicago, IL
Avg $30.31
13,989,780 claims · 5801 providers
Bronx, NY
Avg $82.40
13,626,712 claims · 3705 providers
Phoenix, AZ
Avg $47.53
13,269,420 claims · 4233 providers
Houston, TX
Avg $48.27
8,766,644 claims · 4540 providers
Las Vegas, NV
Avg $54.47
8,578,324 claims · 3512 providers
Other Procedures in Sussex, WI
Speech Therapy
Avg $12.43
14,926 claims
Vaccines & Immunizations
Avg $3.55
11,283 claims
Personal Care Services
Avg $8.61
8,778 claims
Non-Emergency Medical Transportation
Avg $9.70
3,389 claims
Psychiatric Evaluation
Avg $43.03
2,324 claims
Nursing Facility Care
Avg $24.53
623 claims
Eye Exam
Avg $27.04
619 claims
Physical Therapy
Avg $17.85
524 claims