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See a sample rate comparisonCPT 99191 Fee Schedule
Last Verified: September 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.
Oxygen/Heat Pump Assembly, Assembly And Operation Of Pump With Oxygenator Or Heat Exchanger (With Or Without Ecg And/Or Pressure Monitoring); 3/4 Hour
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Other Medicine Services and Procedures |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office 22 - On Campus Outpatient Hospital 23 - Emergency Room |
| Common Modifiers | None 76 - Repeat procedure by same physician GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 99191 |
| Medicaid Fee Schedule | View Medicaid rates for 99191 |
National average reimbursement for CPT 99191 by major payers:
$426.57
$411.28
$337.26
$588.09
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CPT 99191
5 of 25 sample ratesHigher to lower in this preview
Daniel Shapiro
$2,049.66Published rateSohni Reddy
Methodist Hospital
$490.67Published rateBharath Pola
Healthtexas Medical Group
$405.70Published rateSamreen Khuwaja
Texas Primary Care PLLC
$277.39Published rateSyed Zaidi
Southwest Texas Two Medical Group PLLC
$246.57Published rate
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See a sample payer proposalCPT 99191 vs. Other Other Medicine Services and Procedures Codes
The CPT 99191 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 99191 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 |
|---|---|---|
| 99190-CPT | Moderate | Assembly And Operation Of Pump, Assembly And Operation Of Pump With Oxygenator Or Heatexchanger (With Or Without Ecg Andor Pressuremonitoring) Each Hour |
| 99191-CPT | Moderate | Oxygen/Heat Pump Assembly, Assembly And Operation Of Pump With Oxygenator Or Heat Exchanger (With Or Without Ecg And/Or Pressure Monitoring); 3/4 Hour |
| 99192-CPT | Moderate | Oxygen/Heat Pump Assembly, Assembly And Operation Of Pump With Oxygenator Or Heat Exchanger (With Or Without Ecg And/Or Pressure Monitoring); 1/2 Hour |
| 99195-CPT | Low | Phlebotomy, Therapeutic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99191. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99191 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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