CPT 99254 at Island Hospital

Hospital E&M - Initial

Island Hospital, Anacortes

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 Island Hospital publishes for this code: as an outpatient

Island Hospital’s prices for CPT 99254, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	—	$23.04 – $294
Medicare AdvantageInsurer rates	—	$187 – $201
Medicaid managed careInsurer rates	—	$144 – $155
Other government programInsurer rates	—	$130 – $306
Cash pricePaying yourself, without insurance	—	$288 – $309
List priceBefore any discount; few people pay it	—	$288 – $309

Lowest and highest amounts Island Hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. 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 99254 at Island 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	—	—

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

Compare CPT 99254 at every Washington hospital, with Medicare’s reference amounts.