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HCPCS 99204

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more

Reported by 13 hospitals in the network under the other methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a payer-specific billing methodology not covered by the standard categories.

National pricing summary

Low

$128

Average

$181

Median

$148

High

$346

Hospitals reporting this code

#HospitalLocation
1Ukiah Adventist HospitalUkiah, CA$99$117$135$478$37
2Adventist Health Medical Center TehachapiTehachapi, CA$99$188$188$685—
3Sonora Community HospitalSonora, CA$99$117$130$588$33
4Glendale Adventist Medical CenterGlendale, CA$69$122$346$2.2k$536
5Twin Cities Community Hospital IncTempleton, CA$2$118$315$8.4k$459
6Mid Columbia Medical CenterDalles, OR$114$213$213$447—
7Adventist Health DelanoDelano, CA$81$118$154$309$51
8Rideout Memorial HospitalMarysville, CA$38$117$140$314$40
9San Joaquin Community HospitalBakersfield, CA$69$118$142$549$42
10Lodi Memorial Hospital Association IncLodi, CA$99$117$136$834$39
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