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CPT 99204

Office E&M - New

Current code41 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.

See the whole procedure. This code is part of a procedure we compare in full, with every bill and what you’d pay: compare hospitals for it.

What Washington hospitals publish for this code

Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.

HospitalMedicaid (state program) rates (lowest – highest)Cash priceList price (before discounts)
BHC Fairfax HospitalKirkland—$205 – $311$205 – $311
Cascade Medical CenterLeavenworth$271 – $4971 planDoctor’s fee: $312$406 – $744Doctor’s fee: $467$507 – $930Doctor’s fee: $584
Cascade Valley HospitalArlington—$306$383
Coulee Medical CenterGrand Coulee—$532$591
EvergreenHealth MonroeMonroe—$361$451
Grays Harbor Community HospitalAberdeen—$228 – $526$350 – $809
Highline Medical CenterBurienFile dated 2026-02-28—$188$615
Island HospitalAnacortes—$302 – $310Doctor’s fee: $302 – $310$302 – $310Doctor’s fee: $302 – $310
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01—$94.90 – $307Doctor’s fee: $200 – $307$146 – $472Doctor’s fee: $307 – $472
Mason General Hospital & Family of ClinicsShelton—$320 – $356$427 – $474
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$326$627
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$219 – $332$313 – $474
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$252$485
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$282$403
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01——$1.00
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$326$627
Seattle Children's HospitalSeattle$1241 plan—$415
St Anthony HospitalGig HarborFile dated 2026-02-28—$187$615
St Clare HospitalLakewoodFile dated 2026-02-28—$177$615
St Elizabeth HospitalEnumclawFile dated 2026-02-28—$217$615
St Francis Community HospitalFederal WayFile dated 2026-02-28—$193$615
St Joseph Medical CenterTacomaFile dated 2026-02-28—$204$615
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$271$615
Three Rivers HospitalBrewster$66.50 – $2211 planDoctor’s fee: $132 – $282$95.00 – $315Doctor’s fee: $189 – $403$95.00 – $315Doctor’s fee: $189 – $403
Trios HealthKennewick——$822
Virginia Mason Medical CenterSeattle—$72.42$142

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)
$199 in an office; $125 in a hospital or surgery center
Doctor's fee, rest of Washington
$181 in an office; $117 in a hospital or surgery center

How hospitals also write this code

Some price files write it differently. These are counted as CPT 99204:

  • 99204P (with a letter after it, P; 10 price lines)
  • 99204T (with a letter after it, T; 6 price lines)