What does code 99204 cost?

Across the published hospital price files, the disclosed cash price for 99204 ranges from $112 to $2,633. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Will this be my final bill?

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

99204 is the billing code hospitals use to identify "HC OUTPT EVAL AND MGNT NEW PT LEVEL 4" on their published price files. We use it to line up the same service across different hospitals.

Why do prices for this code differ between hospitals?

Each hospital sets its own prices and negotiates separately with each insurer, so the disclosed price for the same code can vary widely from one hospital to another — and even between plans at a single hospital. Comparing the published figures is what this page is for; a difference does not by itself mean one hospital is better or worse.

What this page is not

It is not a quote, a guarantee, or medical advice. It shows what hospitals have published for this code, so you can compare and ask informed questions — your actual cost depends on your insurance, the exact services performed, and the care setting.

99204

HCPCS

HC OUTPT EVAL AND MGNT NEW PT LEVEL 4

Verified from hospital fileNot a bill estimate

iDirect answer

Based on the latest published hospital price files, code 99204 (HC OUTPT EVAL AND MGNT NEW PT LEVEL 4) appears at 26 hospitals with disclosed cash prices from $112 to $2,633. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Published-price availability

hospitals publish a price

list this service without a published price

Cash

List

Negotiated

Allowed

A blank price (“—”) means a hospital names this service but did not publish a dollar amount — it is not a free service or a $0 price.

Compare 99204 prices

Filter by hospital, city, setting, or payer — the summary and charts update with your filters.

Based on hospital-published prices verified from each hospital’s own file. Coverage expands as data is verified.

Published cash prices for code 99204 vary by about 23× across the 24 hospitals with disclosed prices here — from $112 to $2,633. Shopping around can matter.

Hospitals

Prices shown

$112

Lowest cash

$2,633

Highest cash

code 99204 cash price40 disclosed · 24 hospitals

$112median ~$309$2,633

Lowest cash price by hospital

Cash price by city

Reflects your current filters.

Cash price by city$112 – $178

Kalkaska · 1 hospital$112
Charlevoix · 1 hospital$116
Traverse City · 1 hospital$116
Cadillac · 1 hospital$118
Chicago · 1 hospital$178
Libertyville · 1 hospital$178

55 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
HC OUTPT EVAL AND MGNT NEW PT LEVEL 4 Inpatient & outpatient	Endeavor Health Edward Hospital	99204 HCPCS	$1,010	$1,010	—	—
HC OUTPT EVAL AND MGNT NEW PT LEVEL 4 W PROCED Inpatient & outpatient	Endeavor Health Edward Hospital	99204 HCPCS	$1,010	$1,010	—	—
HC PHYSICAL EXAM INTERMEDIATE Inpatient & outpatient	Endeavor Health Edward Hospital	99204 HCPCS	$584	$584	—	—
HC NFPA ANNUAL EXAM Inpatient & outpatient	Endeavor Health Edward Hospital	99204 HCPCS	$584	$584	—	—
HC PHYSICAL EXAM - DOT Inpatient & outpatient	Endeavor Health Edward Hospital	99204 HCPCS	$811	$811	—	—
EH PR OUTPT EVAL AND MGNT NEW PT LEVEL 4 Inpatient & outpatient	Endeavor Health Edward Hospital	99204 HCPCS	$437	$437	—	—
EH PR OUTPT EVAL AND MGNT NEW PT LEVEL 4 W PROCED Inpatient & outpatient	Endeavor Health Edward Hospital	99204 HCPCS	$437	$437	—	—
Office/outpatient visit new Outpatient	Endeavor Health Edward Hospital	99204 HCPCS	—	—	$329 – $329	—
Hc Evaluation And Management New Patient Level 4 Inpatient & outpatient	University of Chicago Medical Center	99204 HCPCS	—	—	—	—
Hc Evaluation And Management New Patient Level 4-Pbb Inpatient & outpatient	University of Chicago Medical Center	99204 HCPCS	—	—	—	—
Pr Office/Outpatient New Moderate Mdm 45 Minutes Inpatient & outpatient	University of Chicago Medical Center	99204 HCPCS	—	—	—	—
New Patient Initial Prenatal Visit 99204 & 0500F For Medicaid Inpatient & outpatient	University of Chicago Medical Center	99204 HCPCS	—	—	—	—
New Patient Initial Prenatal Visit 99204 & 0500F For Medicaid-Pbb Inpatient & outpatient	University of Chicago Medical Center	99204 HCPCS	—	—	—	—
Pr Office/Outpatient New Moderate Mdm 45 Minutes-Pbb Inpatient & outpatient	University of Chicago Medical Center	99204 HCPCS	—	—	—	—
Office/outpatient visit new Outpatient	University of Chicago Medical Center	99204 HCPCS	—	—	—	—
OP SERV HIGH ACUITY-NEW PT Outpatient	Advocate Illinois Masonic Medical Center	99204 CPT	$355	$178	$105 – $289	—
OP SERV HIGH ACUITY-NEW PT Outpatient	Advocate Condell Medical Center	99204 CPT	$355	$178	$105 – $284	—
OSTM OP SERV HIGH ACUITY-NEW PT Outpatient	Advocate Condell Medical Center	99204 CPT	$355	$178	$113 – $284	—
OP SERV HIGH ACUITY-NEW PT Outpatient	Advocate Good Samaritan Hospital	99204 CPT	$355	$178	$105 – $284	—
OP SERV HIGH ACUITY-NEW PT Outpatient	Advocate South Suburban Hospital	99204 CPT	$355	$178	$105 – $346	—
FMS-New PT Visit Only Lvl IV Inpatient	Springfield Memorial Hospital	99204 CPT	$384	$384	$154 – $384	—
FMS-New PT Visit Only Lvl IV Outpatient	Springfield Memorial Hospital	99204 CPT	$384	$384	$86.40 – $384	—
FMS-New PT Visit Only Lvl IV Inpatient	Decatur Memorial Hospital	99204 CPT	$616	$616	$283 – $616	—
FMS-New PT Visit Only Lvl IV Outpatient	Decatur Memorial Hospital	99204 CPT	$616	$616	$150 – $616	—
OP SERV HIGH ACUITY-NEW PT Inpatient	Aurora BayCare Medical Center	99204 CPT	$390	$195	$234 – $332	—

How to read these prices

Cash price: The discounted self-pay price for paying directly, without insurance.
List price: The hospital’s full undiscounted charge — rarely what anyone pays.
Negotiated rate: A rate for a specific insurer and plan; your share depends on your benefits.
Allowed amount: A historical reference for what was actually allowed, where disclosed.

Hospitals that publish 99204 prices

Open a hospital to see this code in the context of its full published prices.

Endeavor Health Edward Hospital University of Chicago Medical Center Advocate Illinois Masonic Medical Center Advocate Condell Medical Center Advocate Good Samaritan Hospital Advocate South Suburban Hospital Springfield Memorial Hospital Decatur Memorial Hospital Aurora BayCare Medical Center Aurora Medical Center Burlington Munson Healthcare Charlevoix Hospital Aurora Medical Center Bay Area Aurora Medical Center Fond du Lac Aurora Medical Center Grafton Aurora Medical Center Kenosha Aurora Lakeland Medical Center Kalkaska Memorial Health Center Munson Healthcare Cadillac Munson Medical Center Three Rivers Health Providence Alaska Medical Center Providence Kodiak Island Medical Center Providence Valdez Medical Center Healdsburg Hospital Providence St Joseph Medical Center Jefferson Abington Hospital

Code 99204: frequently asked

What does code 99204 cost?: Across the published hospital price files, the disclosed cash price for 99204 ranges from $112 to $2,633. This is public hospital price transparency data, not a guaranteed estimate of your bill.
Will this be my final bill?: Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.
What is code 99204?: 99204 is the billing code hospitals use to identify "HC OUTPT EVAL AND MGNT NEW PT LEVEL 4" on their published price files. We use it to line up the same service across different hospitals.
Why do prices for this code differ between hospitals?: Each hospital sets its own prices and negotiates separately with each insurer, so the disclosed price for the same code can vary widely from one hospital to another — and even between plans at a single hospital. Comparing the published figures is what this page is for; a difference does not by itself mean one hospital is better or worse.
What this page is not: It is not a quote, a guarantee, or medical advice. It shows what hospitals have published for this code, so you can compare and ask informed questions — your actual cost depends on your insurance, the exact services performed, and the care setting.

All CPT / HCPCS codes Browse hospitals How to read this data

Hospitals publishing code 99204 by state

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