If you’ve ever looked closely at your medical bill, you may have noticed a time listed next to your visit code—like “45 minutes” for a 99204 or 99214. Some patients wonder, “Why am I being billed for a 45-minute visit when my appointment only lasted 20 minutes?”

This is a very common question, and the short answer is: the time listed in the code name is part of the federal description of the code—not how your bill was calculated.

Let’s break it down.

1. What Those Numbers Mean

Every medical visit is assigned a billing code called a CPT code, which stands for Current Procedural Terminology. These codes are created and standardized by the American Medical Association (AMA) and used nationwide by all insurance companies and healthcare providers.

For example:

• 99204 – New patient visit, moderate to high complexity (CMS includes “45-59 minutes”)
• 99214 – Established patient visit, moderate complexity (CMS includes “30-39 minutes”)

That time you see in parentheses—“45-59 minutes”—is part of the AMA and CMS (Centers for Medicare & Medicaid Services) official code description, not a reflection of how long your visit actually lasted.

2. Dermatologists Bill by Complexity, Not Time

In dermatology (and most medical specialties), office visits are billed based on medical decision-making (MDM)—the complexity of the evaluation, diagnosis, and management—not the duration of the visit.

That means your bill reflects:

• The number and seriousness of the conditions addressed
• The data reviewed or tests ordered
• The risk of complications or management decisions

It does not depend on how long you were in the exam room.

3. Why CMS Includes “Typical Time”

CMS includes a “typical time” with each code to help describe the average amount of time a provider might spend on that type of visit in total, including:

• Reviewing your chart before the visit
• Documenting your note afterward
• Ordering labs or prescriptions
• Coordinating care or referrals

So even if your face-to-face time was short, your provider may have spent significant time behind the scenes managing your care.

4. Example

Let’s say your dermatologist sees you for a changing mole.

• They take your history, review prior biopsy results, perform a detailed skin exam, document findings, and decide that a biopsy is needed.

Even if that visit took only 15–20 minutes in person, the complexity of the medical decision supports a code like 99214, which CMS labels as a “30-39 minute” visit.

5. What to Remember

• The “minutes” listed on your bill are not a timer or clock of your visit.
• Your dermatologist bills based on medical complexity, as required by national coding rules.
• Every practice in the U.S. uses the same CPT codes and definitions set by the AMA and CMS.