CPT 99211 Evaluation & Management
Off/op est may x req phy/qhp Cost
Body System: General
Medicare Facility Rate
$8
CMS PFS CY2026
Medicare Non-Facility Rate
$24
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.18
Work RVU
0.04
Facility PE RVU
0.01
Malpractice RVU
0.73
Total RVU
Frequently Asked Questions
How much does Off/op est may x req phy/qhp cost?
The Medicare facility rate is $8. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Off/op est may x req phy/qhp cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $8.