Evaluation & Management
CPT Code 99214
Office/outpatient visit, established patient, moderate complexity
National Average Rate
$130.00
CMS non-facility rate
Facility Rate
$96.00
Hospital / outpatient facility
Data Source
CMS Medicare
Physician Fee Schedule 2024
What This Means for Your Bill
- Medicare pays $130.00 nationally for CPT 99214 in a non-facility (office) setting.
- In a hospital or outpatient facility the rate drops to $96.00 because the facility bills separately.
- Private insurers typically pay 110–140% of the Medicare rate, so a fair price is roughly $163–$182.
- If your bill shows a charge significantly above this, you may have grounds to negotiate or dispute it.
How to Use This Information
1
Find CPT 99214 on your itemized bill — hospitals are required to provide one on request.
2
Compare the charged amount to $130.00 — if your bill is 2× or more, that's a red flag.
3
Use our AI bill analyzer to scan your full bill, flag errors, and get a dispute letter in under 2 minutes.
Was CPT 99214 on Your Bill?
Upload your bill and our AI will check if you were charged fairly — free in under 2 minutes.
Scan My Bill Free →Related Tools
Look up another CPT code