ENT charged me for procedure, then billed insurance for level 4 office visit

I am not in the medical or insurance profession but this seems kinda shady to me

I recently visited an in network Ear Nose and Throat doctor to discuss my potential candidacy for the Inspire Sleep apnea device. I am a 28 y/o male. My zip code is 78664

I was told by the office staff that the doctor may or may not want to do a nasal endoscopy and if she did opt to do that procedure that my insurance would not cover it and I would be billed at checkout. No worries, I understood and accepted that.

She spent 15 minutes max telling me that unfortunately I was not a candidate and my options moving forward. She did end up doing the procedure (not sure why), ordered an in home sleep study (which I’m also on the hook for 25% of) and sent me on my way. All of this took 30 minutes max.

Went to check out, paid my co-pay and left. I was happy, they were happy.

I received my EOB, claim rejected. Not covered under plan. Did some digging into the code they provided and it was for new patient office visit lasting 40-59 minutes. Code was 99204. So now I’m waiting on the 400 dollar bill to arrive from the doctors office.

It seems shady to me that the office billed for an extended appointment where the majority of the time spent was completing a procedure I already paid for out of pocket. But I also know that I didn’t spend 59 minutes in the office total. I feel like the “medical decision making” portion was 15 minutes max.

She could be completely in the right here, and I absolutely could be wrong but, like health insurance in general, this doesn’t seem fair or right.

Tl;dr- In network Doctor ordered a procedure that I agreed to pay for knowing it wasn’t covered by insurance, then billed insurance for an hour long appointment (99204 code) which was later rejected by insurance.