Office o/p est low 20 min vs Office o/p est mod 30 min
Side-by-side cost comparison of CPT 99213 and CPT 99214 (-32% difference)
CPT 99213
Office o/p est low 20 min
CategoryEvaluation & Management
Body SystemGeneral
Total RVU2.85
Medicare Rate$57
CPT 99214
Office o/p est mod 30 min
CategoryEvaluation & Management
Body SystemGeneral
Total RVU4.06
Medicare Rate$85
Cost Comparison by Setting
Medicare Facility CMS PFS 2026 national facility rate
99213
$57
99214
$85
Medicare Non-Facility CMS PFS 2026 non-facility (office) rate
99213
$95
99214
$136
Hospital Outpatient (OPPS) CMS OPPS hospital outpatient rate
99213
99214
Ambulatory Surgery Center CMS ASC surgery center rate
99213
99214
Est. Commercial (Low) Estimated commercial insurance (150% Medicare)
99213
$86
99214
$127
Est. Commercial (High) Estimated commercial insurance (250% Medicare)
99213
$144
99214
$211
Which One Do You Need?
CPT 99213: Office o/p est low 20 min
This is the lower-cost option in the Evaluation & Management category. It is a less complex procedure (lower RVU) typically requiring less time or fewer resources.
CPT 99214: Office o/p est mod 30 min
This is the higher-cost option in the Evaluation & Management category. It is a more complex procedure (higher RVU) requiring more physician work, time, or resources.
Your doctor determines which CPT code applies based on the specific clinical situation. This comparison is for informational purposes to help you understand the cost differences.