CPT 99453
E&M - Miscellaneous
Current code28 hospitals with prices
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.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Harborview Medical Center | — | $181 | $258 |
| Legacy Salmon Creek Medical Center | — | $13.00 – $37.05 | $20.00 – $57.00 |
| Swedish Issaquah | — | $142 | $295 |
| Swedish Medical Center | — | $142 | $295 |
| Swedish Medical Center / Cherry Hill | — | $142 | $295 |
| University of Washington Medical Ctr | — | $202 | $289 |
| Virginia Mason Medical Center | — | $236 | $462 |
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)
- $26.37 in an office; $26.37 in a hospital or surgery center
- Doctor's fee, rest of Washington
- $22.67 in an office; $22.67 in a hospital or surgery center
- Hospital outpatient payment (national)
- $136 (APC 5012)
How hospitals also write this code
Some price files write it differently. These are counted as CPT 99453:
- 99453P (with a letter after it, P; 4 price lines)
- 99453T (with a letter after it, T; 2 price lines)