Price Checker / CPT 99214
CPT 99214 — Office o/p est mod 30 min
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$85
What Medicare pays in a hospital/ASC setting
$136
What Medicare pays in a physician's office
$4,941
Based on 31 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 99214
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Arroyo Grande Community Hospital Arroyo Grande, CA | $477 | — | 737308% |
| Henderson Hospital Henderson, KY | $248 | — | 346335% |
| Red Bay Hospital , AL | $36,125 | $36,125 | 26539% |
| Long Island Jewish Valley Stream , NY | — | $13,799 | 20251% |
| Phelps Hospital , NY | — | $14,305 | 15301% |
| McLaren Port Huron , MI | $19,904 | $9,952 | 14577% |
| North Arkansas Regional Medical Center Harrison, AR | $17,974 | — | 11166% |
| Park Place Surgical Hospital , LA | $11,933 | — | 8699% |
| PeaceHealth Ketchikan Medical Center , AK | $275 | — | 4121% |
| Columbus Springs Dublin , OH | $2,921 | — | 2054% |
| Phelps Health , MO | $4,378 | — | 1759% |
| Banner Lassen Medical Center , CA | $2,275 | $2,282 | 1578% |
| Banner Page Hospital , AZ | $2,275 | $2,002 | 1578% |
| Banner Payson Medical Center , AZ | $2,275 | $2,204 | 1578% |
| Rainier Springs , WA | $125 | — | 907% |
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About CPT 99214
CPT code 99214 refers to “Office o/p est mod 30 min”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $85 in a facility (hospital or ambulatory surgery center) and $136in 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.