Price Checker / CPT 99212

How much does Office visit — short (established patient) cost?

CPT 99212 · Based on 2026 Medicare rates and hospital-published pricing

Overpriced

The average hospital charge is about above the fair price. You have grounds to ask for a reduction.

Fair price

$210–$250

What this should cost

With insurance

~$303,500

Typical out-of-pocket

Overcharged if over

$310

Push back above this

The average hospital charge of $330 is $100 over the fair price.

What hospitals charge for Office visit — short (established patient)

From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.

HospitalGross ChargeCash Ratevs Medicare
PeaceHealth Peace Harbor Medical Center

, OR

$3559732%
PeaceHealth Ketchikan Medical Center

KETCHIKAN, AK

$2199529%
Columbus Springs Dublin

, OH

$2,9214813%
Rainier Springs

VANCOUVER, WA

$752196%
Copper Springs

, AZ

$751895%
Iroquois Memorial Hospital

WATSEKA, IL

$365$255513%
Connally Memorial Health Centers - Main Campus

Floresville, TX

$102270%
Connally Memorial Health Centers - North Campus

Floresville, TX

$102217%
UPMC Western Psychiatric

, PA

$165$132178%
Connally Memorial Health Centers - La Vernia Campus

Floresville, TX

$102162%
Barnes-Kasson County Hospital

SUSQUEHANNA, PA

$125$88110%
Pine Rest Christian Mental Health Services

GRAND RAPIDS, MI

$120$96102%
Pathways Behavioral Health Services

, TN

$103$10373%
Highland Springs LLC

BEACHWOOD, OH

$75$95026%
Molokai General Hospital

KAUNAKAKAI, HI

$32617%

Were you billed for this procedure?

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About Office visit — short (established patient)

CPT code 99212 refers to office visit — short (established patient) (billing description: "Office o/p est sf 10 min"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $31 in a facility (hospital or surgery center) and $59 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

  1. 1Send us your billwe'll identify this code and compare it against the rates shown above.
  2. 2Get a dispute letterciting the Medicare rate and your hospital's own published pricing data.
  3. 3We negotiate for you25% of savings, no savings = no fee.

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