Office visit · CPT 99213

What is CPT code 99213?

Established-patient office visit, low complexity.

By Justin Feldstein · Reviewed 2026-06-15

What it covers

A standard follow-up with a doctor you've seen before. It covers a medically appropriate history and exam plus low-complexity decision-making, the everyday appointment for a known condition, a medication check, or a minor new issue. It's one of the most common codes on any medical bill precisely because it fits so many routine visits, which also makes it a useful baseline to compare your own appointment against.

When you'd see it

You'll see this after a routine 20-to-30-minute appointment with your primary care doctor or a specialist you already see.

Roughly what it costs

$90–$200 commonly billed

A ballpark on the billed amount. After insurance or a negotiated rate, what you owe is often far lower. Always compare against your Explanation of Benefits (EOB).

What's usually billed with it

Routinely accompanied by labs, an EKG (93000), or a blood draw (36415) when the doctor orders follow-up testing; those are separate, legitimate lines.

99213 vs 99214

99214 reflects more history, a broader exam, or managing a condition that needs real adjustment, so a simple check-in should stay at 99213 rather than rise to 99214. See 99214 (established-patient, moderate complexity).

What to watch for

This is one of the most common codes on any bill. If you only had a quick check-in, make sure it wasn't billed as the higher-complexity 99214 or 99215 instead.

Specific things to question

• Whether a quick, simple visit was billed up to the higher 99214 or 99215.
• Whether ordered tests appear as their own lines (normal) or are duplicated.
• Whether the documented time and decision-making actually support this level versus the lower 99212.

How to check this charge on your own bill

Find 99213 on your itemized bill and match it against your EOB. Confirm it appears only once, that any bundled services aren't also billed separately, and that the amount matches what your insurer says it allowed. If something doesn't line up, that's a fair question for the billing office.