Price Checker / CPT 99211
CPT 99211 — Off/op est may x req phy/qhp
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$8
What Medicare pays in a hospital/ASC setting
$24
What Medicare pays in a physician's office
$1,485
Based on 79 hospital(s) in our database
What do these numbers mean?
The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.
Hospital Charges for CPT 99211
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| UCSF Health Saint Francis Hospital San Francisco, CA | $215 | — | 4101722619% |
| Arroyo Grande Community Hospital Arroyo Grande, CA | $298 | — | 4101619% |
| Dominican Hospital Santa Cruz, CA | $1,452 | — | 4101619% |
| WTH Dyersburg Hospital , TN | — | $41 | 42319% |
| The Medical Center , KY | $10,069 | — | 41200% |
| Long Island Jewish Valley Stream , NY | — | $4,632 | 37898% |
| South Shore University Hospital , NY | — | $4,632 | 37898% |
| Syosset Hospital , NY | — | $4,632 | 37898% |
| Huntsville Hospital , AL | $9,064 | $9,064 | 37076% |
| Phelps Hospital , NY | — | $4,632 | 27639% |
| PeaceHealth Peace Harbor Medical Center , OR | $267 | — | 23876% |
| PeaceHealth Ketchikan Medical Center , AK | $156 | — | 23381% |
| Grundy County Memorial Hospital , IA | $3,555 | — | 14482% |
| 45-2896080 MBMC Leake , MS | $3,167 | $1,425 | 12890% |
| 47-3684354 MBMC Attala , MS | $3,167 | $1,393 | 12890% |
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About CPT 99211
CPT code 99211 refers to “Off/op est may x req phy/qhp”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $8 in a facility (hospital or ambulatory surgery center) and $24in a non-facility (physician's office) setting.
These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.
What to do if you were overcharged
- Upload your bill— we'll identify this code and compare it against the rates shown above.
- Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
- Negotiate or let us handle it — 25% of savings, no savings = no fee.