CPT 99454
E&M - Miscellaneous
Current code29 hospitals with prices
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Harborview Medical Center | — | $80.98 | $116 |
| Legacy Salmon Creek Medical Center | — | $27.95 – $80.60 | $43.00 – $124 |
| Swedish Issaquah | — | $154 | $320 |
| Swedish Medical Center | — | $154 | $320 |
| Swedish Medical Center / Cherry Hill | — | $154 | $320 |
| University of Washington Medical Ctr | — | $88.07 | $126 |
| Virginia Mason Medical Center | — | $99.96 | $196 |
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)
- $63.80 in an office; $63.80 in a hospital or surgery center
- Doctor's fee, rest of Washington
- $54.77 in an office; $54.77 in a hospital or surgery center
- Hospital outpatient payment (national)
- $38.13 (APC 5741)
How hospitals also write this code
Some price files write it differently. These are counted as CPT 99454:
- 99454P (with a letter after it, P; 4 price lines)
- 99454T (with a letter after it, T; 2 price lines)