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See a sample rate comparisonCPT 99170 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Genital Exam Of Child, Exam Of The Anus And Genitals Of A Child With A Magnifying Scope (Colposcope). This Exam Is Given When Injury From Abuse Is Suspected.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Other Medicine Services and Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service 25 - Significant, separately identifiable E/M service same day |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99170 |
| Medicaid Fee Schedule | View Medicaid rates for 99170 |
National average reimbursement for CPT 99170 by major payers:
$199.75
$194.82
$192.76
$148.53
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CPT 99170
5 of 25 sample ratesHigher to lower in this preview
Vaqar Dar
Texas Health Physicians Group
$522.57Published rateDorothy Chen
East Boston Neighborhood Health Center Corp
$309.64Published rateYone Scaramelli Dos Santos
Tallahassee Memorial Healthcare Inc
$190.00Published rateCharisse Barta
Charisse H Barta Md PA
$137.42Published rateC Care Cardiovascular Center
$66.76Published rate
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See a sample payer proposalCPT 99170 vs. Other Other Medicine Services and Procedures Codes
The CPT 99170 code is part of the Medicine Services and Procedures services used for Other Medicine Services and Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 99170 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 99075-CPT | Low | Testimony For A Legal Case, Testimony By A Health Care Professional About Medical Care That Is Provided To A Medical Board In A Deposition Or As A Witness In A Court Case. |
| 99078-CPT | Low | Group Health Education, Physician Or Other Qualified Health Care Professional Qualified By Education Training Licensure Regulation When Applicable Educational Services Rendered To Patients In A Group Setting Eg Prenatal Obesity Or Diabetic Instructions |
| 99170-CPT | Low | Genital Exam Of Child, Exam Of The Anus And Genitals Of A Child With A Magnifying Scope (Colposcope). This Exam Is Given When Injury From Abuse Is Suspected. |
| 99175-CPT | Low | Poisoning Treatment, Treatment For Poisoning Including Administration Of Ipecac To Induce Vomiting And Observation Until The Stomach Is Completely Emptied. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99170. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99170 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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