CPT 99204 at Summit Pacific Medical Center

Office E&M - New

Summit Pacific Medical Center, Elma

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.

See the whole procedure. This code is part of a procedure we compare in full: every bill and what you’d pay at Summit Pacific Medical Center.

What Summit Pacific Medical Center publishes for this code: as an outpatient

Summit Pacific Medical Center’s prices for CPT 99204, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$362 – $4653 plans	$91.84
Medicare AdvantageInsurer rates	$375 – $3873 plans	—
Medicaid managed careInsurer rates	$119 – $1313 plans	$91.84 – $101
Other government programInsurer rates	$3751 plan	$117
UnknownInsurer rates	$119 – $4142 plans	$91.84 – $162
Cash pricePaying yourself, without insurance	$279	$279
List priceBefore any discount; few people pay it	$517	$517

Lowest and highest amounts Summit Pacific 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 2026-08-31. 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.

Bills to expect for CPT 99204 at Summit Pacific Medical Center
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The clinic's facility fee, when the clinic belongs to the hospital	—	The price above
Doctor's visitThe doctor's practice	The visit itself	$117	$138 – $210

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

Compare CPT 99204 at every Washington hospital, with Medicare’s reference amounts.