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Every billing code / CPT 42104 / Olympic Medical Center

CPT 42104 at Olympic Medical Center

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Olympic Medical Center, Port Angeles

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

What Olympic Medical Center publishes for this code: as an outpatient

Who paysHospital’s fee (lowest – highest)Doctor’s fee the hospital lists
Medicare AdvantageInsurer rates$4,155 – $5,3425 plans—
Medicaid managed careInsurer rates$2,540 – $2,7825 plans—
Cash pricePaying yourself, without insurance——
List priceBefore any discount; few people pay it——

Lowest and highest amounts Olympic Medical Center lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-06-24. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

BillWhat it’s forOriginal Medicare allowsPrivate plan estimate
Hospital's feeThe hospitalThe operating or procedure room, nursing, supplies and recovery—The price above
Surgeon or doctor doing itThe doctor's practiceThe procedure, and routine follow-up visits for 10 days$125$147 – $223
AnesthesiaAn anesthesia group (only sometimes)Anesthesia or deep sedation, if you need itOnly if an anesthesia team is part of your care. Its amount depends on how long it takes.——

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare CPT 42104 at every Washington hospital, with Medicare’s reference amounts.