CPT 99231

Hospital E&M - Subsequent

Current code17 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

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for CPT 99231 by hospital
Hospital	Medicaid managed care rates (lowest – highest)	Cash price	List price (before discounts)
Cascade Medical CenterLeavenworth	$91.79 – $1884 plans	$132 – $180	$165 – $225
Coulee Medical CenterGrand Coulee	—	$129	$143
Island HospitalAnacortes	$57.501 plan	$115	$115
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01	—	$51.10	$73.00
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01	—	—	—
PeaceHealth Peace Island Medical CenterFriday Harbor	—	Doctor’s fee: $78.00	Doctor’s fee: $120
PeaceHealth Southwest Medical CenteVancouver	$46.081 plan	$98.15	$151
PeaceHealth St Joseph Medical CenterBellingham	$46.532 plans	$98.15	$151
Providence Centralia HospitalCentraliaFile dated 2026-04-01	—	$46.80	$90.00
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01	—	$65.10	$93.00
Providence Regional Medical Center EverettEverettFile dated 2026-04-01	—	$52.00	$100
Providence St Joseph HospitalChewelahFile dated 2026-04-01	—	$65.10	$93.00
Providence St Peter HospitalOlympiaFile dated 2026-04-01	—	$46.80	$90.00
Seattle Children's HospitalSeattle	$39.03 – $41.687 plans	—	$152
Three Rivers HospitalBrewster	Doctor’s fee: $104 – $109	Doctor’s fee: $149 – $156	Doctor’s fee: $149 – $156
Virginia Mason Medical CenterSeattle	—	—	—
WhidbeyHealth Medical CenterCoupeville	—	$89.00 – $250	$89.00 – $250

Lowest and highest amounts each hospital lists for this code as an outpatient, 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): $47.09 in a hospital or surgery center
Doctor's fee, rest of Washington: $44.31 in a hospital or surgery center