CPT 99423 Evaluation & Management

Ol dig e/m svc 21+ min Cost

Body System: General

Medicare Facility Rate

$35

CMS PFS CY2026

Medicare Non-Facility Rate

$49

Office/clinic setting

Relative Value Units (RVUs)

Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)

0.80

Work RVU

0.20

Facility PE RVU

0.05

Malpractice RVU

1.46

Total RVU

Frequently Asked Questions

How much does Ol dig e/m svc 21+ min cost?

The Medicare facility rate is $35. Commercial insurance typically pays 150-250% of Medicare rates (varies).

How much does Ol dig e/m svc 21+ 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 $35.