CPT 99213: Office/Outpatient Visit — Established Patient, Level 3
A typical established-patient office visit involving straightforward to moderate medical decision making.
Category: Office Visit | Typical bill: $100 - $300
⚠️ Prior authorization: No
🎯 Am I being overcharged?
Enter what your bill says for CPT 99213 and we'll flag it against a typical fair range for this service.
Why your Office/Outpatient Visit — Established Patient, Level 3 bill looks so high
Hospitals bill a "rack rate" that is often 2-10x higher than what Medicare pays or what insurers actually reimburse. The fair range for CPT 99213 is roughly $100 - $300 — but many facilities bill far beyond it.
Common reasons 99213 claims get denied
- Visit not covered due to plan deductible being met incorrectly. Verify the deductible was applied to the proper benefit year and that the visit was to an in-network PCP.
Office visit disputes are usually billing-level errors (wrong plan year applied). Pull the EOB and check the math.
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