Price Checker / CPT 99215
CPT 99215 — Office o/p est hi 40 min
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$126
What Medicare pays in a hospital/ASC setting
$192
What Medicare pays in a physician's office
$1,110
Based on 25 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 99215
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Dominican Hospital Santa Cruz, CA | $291 | — | 519677% |
| Beloit Memorial Hospital , WI | $12,009 | $3,603 | 6142% |
| PeaceHealth Ketchikan Medical Center , AK | $345 | — | 2876% |
| Banner Lassen Medical Center , CA | $3,205 | $3,215 | 1566% |
| Banner Page Hospital , AZ | $3,205 | $2,820 | 1566% |
| Banner Payson Medical Center , AZ | $3,205 | $3,106 | 1566% |
| 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% |
| Lindner Center of Hope , OH | $345 | $204 | 79% |
| Northeast Texas Rural Health Clinic Mt. Pleasant, TX | $425 | — | 77% |
| Lindner Center of Hope , OH | $345 | — | 75% |
| Mackinac Straits Health System Saint Ignace, MI | $361 | — | 72% |
| Northeastern Center , IN | $315 | — | 64% |
| Pine Rest Christian Mental Health Services , MI | $301 | $241 | 56% |
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About CPT 99215
CPT code 99215 refers to “Office o/p est hi 40 min”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $126 in a facility (hospital or ambulatory surgery center) and $192in 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.