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CPT 99423Medical 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 21 or more minutes. Clinical pricing breakdown and utilization metrics across 221 practicing doctors nationwide.

$100.00
Peer Median Charge
Gross billed rate
$45.02
Standard Baseline
Customary allowable
2.2x
National Markup
Charge vs baseline
221
Active Physicians
Billing this code
Planning care or already received a bill for CPT 99423?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 $100.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $45.02 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 99423 if paid upfront?"
  • "Are there separate facility, anesthesia, or pathology fees associated with this procedure?"