Price Checker / CPT 99415
CPT 99415 — Prolng clin staff svc 1st hr
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$23
What Medicare pays in a hospital/ASC setting
$23
What Medicare pays in a physician's office
$58
Based on 1 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 99415
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| UPMC Western Psychiatric , PA | $58 | $46 | 152% |
Were you billed for this procedure?
Upload your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free, 60 seconds.
About CPT 99415
CPT code 99415 refers to “Prolng clin staff svc 1st hr”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $23 in a facility (hospital or ambulatory surgery center) and $23in 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.