CPT 96161

E&M - Miscellaneous

Current code29 hospitals with prices

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 Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Prices for CPT 96161 by hospital
Hospital	Medicare Advantage rates (lowest – highest)	Cash price	List price (before discounts)
EvergreenHealth Medical CenterKirkland	$32.01 – $32.635 plans	$59.20	$74.00
Island HospitalAnacortes	$44.72 – $47.4011 plans	$7.00	$7.00
Providence Regional Medical Center EverettEverettFile dated 2026-04-01	—	$45.24 – $49.92	$87.00 – $96.00
Swedish IssaquahIssaquahFile dated 2026-04-01	—	$40.32	$84.00
Swedish Medical CenterSeattleFile dated 2026-04-01	—	$40.32	$84.00
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01	—	$40.32	$84.00
Virginia Mason Medical CenterSeattle	—	$61.71	$121

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Doctor's fee, Seattle (King County): $4.10 in an office; $4.10 in a hospital or surgery center
Doctor's fee, rest of Washington: $3.52 in an office; $3.52 in a hospital or surgery center
Hospital outpatient payment (national): $38.28 (APC 5821)