How do Medicare & Medicaid rates affect fee schedules?

Medicare & Medicaid rates are government-set reimbursement amounts that influence fee schedules.

How does Geographic Location affect fee schedules?

Costs may be higher in urban areas compared to rural areas, leading to variations in fee schedules based on geographic location.

How does Provider Type affect fee schedules?

Hospital providers may have different rates than private practice settings, influencing fee schedules based on provider type.

How can I find out the cost of a medical procedure?

The cost of medical procedures can vary significantly based on the provider, location, and your insurance plan. To get an estimate for specific CPT codes in your area, you can use online tools designed for price transparency. For a detailed lookup based on a CPT code and specific location, it is recommended to check Payerprice's fee schedule lookup tool.

What is a CPT code and how is it used?

CPT stands for Current Procedural Terminology. CPT codes are a set of standardized five-digit codes that describe medical, surgical, and diagnostic services and procedures performed by healthcare providers. They are used by healthcare professionals and insurers to accurately document and bill for services, facilitating the processing of claims and managing healthcare data.

Where can I find information about fee schedules for medical services?

Fee schedules outline the maximum amount an insurance company will pay for a specific medical service or procedure. For users looking to research fee schedules for particular CPT codes and locations, it is recommended to utilize tools like Payerprice, which offers a fee schedule lookup tool to search with CPT codes and specific geographical areas.

Do insurance companies all pay the same amount for the same service?

No, insurance companies do not typically pay the same amount for the same service. Reimbursement rates can vary widely depending on the specific insurance plan, the negotiation between the insurer and the healthcare provider (in-network vs. out-of-network), geographic location, and other factors.

What should I do if I receive an unexpected medical bill?

If you receive an unexpected medical bill, first review it carefully for accuracy. Compare it with your Explanation of Benefits (EOB) from your insurance company to understand what was covered and what you might owe. Contact your healthcare provider's billing department to ask for an itemized bill and clarity on the charges. You should also contact your insurance company to understand why certain services were not covered or why the cost is higher than expected. For future reference or to compare the billed amount with typical costs, you could use tools like Payerprice to research general fee schedules for specific procedures.

CPT 99183 Fee Schedule

Q: How do Private Insurance Rates affect fee schedules?

Private insurance rates are negotiated rates between providers and insurance companies, significantly impacting fee schedules.

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.

Physician Or Other Qualified H, Physician Or Other Qualified Health Care Professional Attendance And Supervision Of Hyperbaric Oxygen Therapy Per Session

Key Fact	Detail
Service Type	Medicine Services and Procedures Other Medicine Services and Procedures
Common Place of Service	22 - On Campus Outpatient Hospital 11 - Office 19 - Off Campus Outpatient Hospital
Common Modifiers	None 59 - Distinct Procedural Service GC - Service performed by resident under supervision
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 99183
Medicaid Fee Schedule	View Medicaid rates for 99183

National average reimbursement for CPT 99183 by major payers:

$178.26

$184.27

$174.64

$176.36

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 99183.

CPT 99183

5 of 25 sample ratesHigher to lower in this preview

Alexandra Halevi
COSurgery PhysicianNPI 1164841334Tax ID 68-0334324
$471.70Published rate
Steven Moulton
University Physicians Incorporated
COPediatric Surgery PhysicianNPI 1700849924Tax ID 74-2161737
$309.04Published rate
Sumant Rawat
Sumant Rawat Md
COSpecialistNPI 1710930672Tax ID 20-1426635
$246.72Published rate
Sarah Schutte
COSpecialistNPI 1902844624Tax ID 90-0733283
$196.17Published rate
Pauline Morrow
Clarity Dermatology, PLLC
COSpecialistNPI 1629142484Tax ID 82-2302435
$114.04Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 99183 vs. Other Other Medicine Services and Procedures Codes

The CPT 99183 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 99183 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
99175-CPT	Low	Poisoning Treatment, Treatment For Poisoning Including Administration Of Ipecac To Induce Vomiting And Observation Until The Stomach Is Completely Emptied.
99183-CPT	Low	Physician Or Other Qualified H, Physician Or Other Qualified Health Care Professional Attendance And Supervision Of Hyperbaric Oxygen Therapy Per Session

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99183. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 99183 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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CPT 99183 Fee Schedule

Alexandra Halevi

Steven Moulton

Sumant Rawat

Sarah Schutte

Pauline Morrow