CPT 99305 Evaluation & Management
1st nf care moderate mdm 35 Cost
Body System: General
Medicare Facility Rate
$120
CMS PFS CY2026
Medicare Non-Facility Rate
$141
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
2.50
Work RVU
0.91
Facility PE RVU
0.18
Malpractice RVU
4.22
Total RVU
Frequently Asked Questions
How much does 1st nf care moderate mdm 35 cost?
The Medicare facility rate is $120. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does 1st nf care moderate mdm 35 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 $120.