Price Checker / CPT 99211
How much does Off/op Est May X Req Phy/qhp cost?
CPT 99211 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 31x the fair price — among the most extreme markups. Dispute this.
Fair price
$35–$75
What this should cost
With insurance
~$209,700
Typical out-of-pocket
Overcharged if over
$95
Push back above this
The average hospital charge of $1,716 is $1,661 over the fair price (about 31x the fair rate).
What hospitals charge for Off/op Est May X Req Phy/qhp
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| WTH Dyersburg Hospital , TN | — | $41 | 42319% |
| Long Island Jewish Valley Stream , NY | — | $4,632 | 37898% |
| South Shore University Hospital , NY | — | $4,632 | 37898% |
| Syosset Hospital , NY | — | $4,632 | 37898% |
| Phelps Hospital SLEEPY HOLLOW, NY | — | $4,632 | 27639% |
| PeaceHealth Peace Harbor Medical Center , OR | $267 | — | 23876% |
| PeaceHealth Ketchikan Medical Center KETCHIKAN, AK | $156 | — | 23381% |
| Grundy County Memorial Hospital GRUNDY CENTER, IA | $3,555 | — | 14482% |
| Columbus Springs Dublin , OH | $2,921 | — | 11881% |
| Oregon Health and Science University , OR | $2,000 | $1,300 | 8103% |
| Rainier Springs VANCOUVER, WA | $50 | — | 5499% |
| EHHS Fulton Square Clinic , WI | $1,229 | $897 | 4941% |
| Copper Springs , AZ | $50 | — | 4765% |
| 62-1113167 BMH Tipton , TN | $782 | $188 | 3108% |
| Dodge County Hospital EASTMAN, GA | $514 | $308 | 2009% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Off/op Est May X Req Phy/qhp
CPT code 99211 refers to off/op est may x req phy/qhp (billing description: "Off/op est may x req phy/qhp"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $8 in a facility (hospital or surgery center) and $24 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.