How much does established patient office visit, low complexity cost in Virginia?

CPT 99213 — the fair price, every hospital's price, and the Medicare benchmark for Virginia.

Estimates only. Educational estimates from public Medicare benchmarks and hospital-published prices — not a guarantee, and not legal, medical, or financial advice.
99213 Established patient office visit, low complexity
Market typical price
$160
51 facilities · typical range $79 – $309 · 1.8× Medicare PFS
What Medicare pays
$89
Market typical
$160
Cash / self-pay price
$192
Prices near you — 51 facilities, lowest first
FacilityTypePricevs MedicareQuality
UVA Health University Medical Center (Charlottesville) lowest Hospital $35cash 0.4× ★★★★★
hip/knee complications 4.3%
Ballad Health Johnston Memorial Hospital (Abingdon) Hospital $36cash 0.4× ★★★★★
hip/knee complications 6.2%
Ballad Health Lonesome Pine Hospital (Big Stone Gap) Hospital $36cash 0.4× ★★★★★
Ballad Health Russell County Hospital (Lebanon) Hospital $36cash 0.4× ★★★★★
Ballad Health Smyth County Community Hospital (Marion) Hospital $36cash 0.4× ★★★★★
hip/knee complications 4.4%
Sentara CarePlex Hospital (Hampton) Hospital $66negotiated 0.7× ★★★★★
Sentara Leigh Hospital — orthopedic-focused (Norfolk) Hospital $66negotiated 0.7× ★★★★★
hip/knee complications 6.2%
Sentara Norfolk General Hospital (Norfolk) Hospital $66negotiated 0.7× ★★★★★
Sentara Obici Hospital (Suffolk) Hospital $66negotiated 0.7× ★★★★★
hip/knee complications 5.6%
Sentara Princess Anne Hospital (Virginia Beach) Hospital $66negotiated 0.7× ★★★★★
Sentara Virginia Beach General Hospital (Virginia Beach) Hospital $66negotiated 0.7× ★★★★★
hip/knee complications 3.7%
Sentara Williamsburg Regional Medical Center (Williamsburg) Hospital $66negotiated 0.7× ★★★★★
hip/knee complications 5.6%
Prices from each hospital's public machine-readable file; imaging & surgery-center prices are published self-pay rates (often the cheapest option). vs Medicare is how many times the Medicare rate each facility charges.
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What should 99213 cost in Virginia?

For established patient office visit, low complexity (CPT 99213) in Virginia, a fair self-pay price is around $160, with hospitals ranging from $79 to $309 across 51 facilities. Medicare's benchmark rate is $89, the benchmark every published rate is measured against. The card above lists each hospital's price, cheapest first, with CMS quality stars.

Frequently asked questions

How much does established patient office visit, low complexity cost in Virginia?

A fair self-pay price for established patient office visit, low complexity (CPT 99213) in Virginia is around $160, with hospital prices ranging from $79 to $309 across 51 facilities. These are estimates from hospital-published prices, not a guarantee.

What is the Medicare rate for CPT 99213?

Medicare pays about $89 for established patient office visit, low complexity (CPT 99213). That's the negotiation floor — a fair cash-pay target is roughly 1.5–2× it, well below typical gross charges.

Can I negotiate the price of established patient office visit, low complexity?

Yes. Under the federal Hospital Price Transparency rule hospitals must publish these rates, so you can ask to pay the cash or negotiated rate instead of the gross charge. Paste your bill on the home page for a ready-to-send appeal letter and the exact numbers to cite.

Placing a referral for this?

Enter the patient's ZIP and plan in the facility finder to see every facility near them that publishes a price for 99213, ranked, with the phone number and an out-of-pocket estimate.

Compare other procedures in Virginia

Total knee replacement (arthroplasty)Total hip replacement (arthroplasty)Partial (unicompartmental) knee replacementTotal shoulder replacement (arthroplasty)Revision total knee replacementRevision total hip replacementMajor hip/knee joint replacement, inpatient, w/o MCCMajor hip/knee joint replacement, inpatient, w/ MCC

Prices last refreshed September 2026 from each hospital's official CMS machine-readable file. Medicare rate: CY2025 OPPS/PFS/CLFS. Estimates only — not a guarantee.