CPT 99407 Evaluation & Management
Behav chng smoking > 10 min Cost
Body System: General
Medicare Facility Rate
$22
CMS PFS CY2026
Medicare Non-Facility Rate
$29
Office/clinic setting
Hospital Outpatient
$38
OPPS rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.50
Work RVU
0.12
Facility PE RVU
0.04
Malpractice RVU
0.87
Total RVU
Frequently Asked Questions
How much does Behav chng smoking > 10 min cost?
The Medicare facility rate is $22. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $38.
How much does Behav chng smoking > 10 min 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 $22.