CPT 99204 at Forks Community Hospital

Office E&M - New

Forks Community Hospital, Forks

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 Forks Community Hospital.

What Forks Community Hospital publishes for this code: as an outpatient

Forks Community Hospital’s prices for CPT 99204, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$274 – $6394 plans	$117 – $174
Medicare AdvantageInsurer rates	$236 – $5575 plans	$61.95
Medicaid managed careInsurer rates	$221 – $2845 plans	$91.84 – $97.35
Other government programInsurer rates	$236 – $2882 plans	$117 – $118
UnknownInsurer rates	$368 – $6394 plans	$142 – $179
Cash pricePaying yourself, without insurance	$511	$142
List priceBefore any discount; few people pay it	$639	$177

Lowest and highest amounts Forks Community Hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-10-27. 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 Forks Community Hospital
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.