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CPT 99421Medical Service

Online Digital Evaluation and Management Service for an Established Patient for Up to 7 Days

Online digital evaluation and management service for an established patient for up to 7 days, total time 5-10 minutes. Clinical pricing breakdown and utilization metrics across 1,088 practicing doctors nationwide.

$41.57
Peer Median Charge
Gross billed rate
$14.26
Standard Baseline
Customary allowable
2.9x
National Markup
Charge vs baseline
1,088
Active Physicians
Billing this code
Planning care or already received a bill for CPT 99421?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $41.57. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $14.26 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:
  • "Does Dr. [Name] participate in my specific insurance plan network?"
  • "What is the total self-pay or cash rate for code 99421 if paid upfront?"
  • "Are there separate facility, anesthesia, or pathology fees associated with this procedure?"