CPT 99243

Office/Outpatient Services

Current code19 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 managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for CPT 99243 by hospital
HospitalMedicaid managed care rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27———
Cascade Medical CenterLeavenworth$281 – $4234 plans$405$506
Cascade Valley HospitalArlington$2661 plan$213$266
Coulee Medical CenterGrand Coulee—$415$461
Island HospitalAnacortes$86.50 – $1501 plan$173 – $300$173 – $300
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27———
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27———
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27———
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27———
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01———
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$158$225
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$163$314
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$106$151
Seattle Children's HospitalSeattle$70.26 – $75.039 plans—$274
Skagit Valley HospitalMount Vernon$1091 plan$124$155
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27———
Three Rivers HospitalBrewster$29.051 planDoctor’s fee: $154 – $183$41.50Doctor’s fee: $220 – $261$41.50Doctor’s fee: $220 – $261
WhidbeyHealth Medical CenterCoupeville—$285$285
Yakima Valley MemorialYakimaFile dated 2026-08-27———

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

CMS publishes no national amount for this code.