Price Checker / CPT 99215
How much does Office visit — complex (established patient) cost?
CPT 99215 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is in line with what this normally costs. No need to dispute.
Fair price
$450–$530
What this should cost
With insurance
~$349,100
Typical out-of-pocket
Overcharged if over
$660
Push back above this
What hospitals charge for Office visit — complex (established patient)
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| PeaceHealth Ketchikan Medical Center KETCHIKAN, AK | $345 | — | 2876% |
| UM R Adams Cowley Shock Trauma Center Baltimore, MD | $540 | — | 180% |
| UPMC Western Psychiatric , PA | $527 | $422 | 174% |
| Pennsylvania Psychiatric Institute Harrisburg, PA | $480 | — | 100% |
| Northeast Texas Rural Health Clinic Mt. Pleasant, TX | $425 | — | 77% |
| Lindner Center of Hope MASON, OH | $345 | — | 75% |
| Mackinac Straits Health System Saint Ignace, MI | $361 | — | 72% |
| Northeastern Center AUBURN, IN | $315 | — | 64% |
| Pine Rest Christian Mental Health Services GRAND RAPIDS, MI | $301 | $241 | 56% |
| Aspire Health Partners, Inc Orlando, FL | $180 | — | 45% |
| Barnes-Kasson County Hospital SUSQUEHANNA, PA | $257 | $180 | 34% |
| JD McCarty Center Norman, OK | $180 | — | 33% |
| NATCHAUG HOSPITAL MANSFIELD CENTER, CT | $212 | — | 19% |
| Connally Memorial Health Centers - Main Campus Floresville, TX | $177 | — | 14% |
| Serenity Springs Specialty Hospital Ruston, LA | $200 | — | 4% |
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 Office visit — complex (established patient)
CPT code 99215 refers to office visit — complex (established patient) (billing description: "Office o/p est hi 40 min"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $126 in a facility (hospital or surgery center) and $192 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.