# CPT 99221: Initial hospital inpatient or observation care, straightforward to low medical decision making

Medicare CPT 99221 pays $74.48 in a non-facility setting and $74.48 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $69.48 in Nebraska to $99.75 in Alaska, a 44% spread.

Web page: https://www.med-reveal.com/rates/99221-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation, General Acute Care Hospital, Hematology & Oncology, Infectious Disease, Internal Medicine, Neurological Surgery, Neurology, Plastic Surgery, Psychiatry & Neurology, Pulmonary Disease, Thoracic Surgery (Cardiothoracic Vascular Surgery), Vascular Surgery

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $74.48 |
| National facility | $74.48 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $99.75 | $99.75 |
| New York | $80.93 | $80.93 |
| District of Columbia | $80.58 | $80.58 |
| Florida | $80.54 | $80.54 |
| Illinois | $79.99 | $79.99 |
| New Jersey | $79.54 | $79.54 |
| Connecticut | $77.96 | $77.96 |
| Washington | $76.78 | $76.78 |
| Massachusetts | $76.73 | $76.73 |
| Maryland | $76.27 | $76.27 |
| Michigan | $76.24 | $76.24 |
| California | $76.04 | $76.04 |
| West Virginia | $75.43 | $75.43 |
| Rhode Island | $75.28 | $75.28 |
| Georgia | $75.18 | $75.18 |
| Pennsylvania | $75.13 | $75.13 |
| Colorado | $74.62 | $74.62 |
| New Mexico | $74.62 | $74.62 |
| Puerto Rico | $74.54 | $74.54 |
| Virgin Islands | $74.54 | $74.54 |
| Montana | $74.47 | $74.47 |
| New Hampshire | $74.25 | $74.25 |
| Texas | $74.12 | $74.12 |
| Delaware | $73.95 | $73.95 |
| Oregon | $73.90 | $73.90 |
| Hawaii | $73.69 | $73.69 |
| Louisiana | $73.59 | $73.59 |
| Nevada | $73.44 | $73.44 |
| Ohio | $73.34 | $73.34 |
| Missouri | $73.26 | $73.26 |
| Arizona | $73.15 | $73.15 |
| Utah | $73.02 | $73.02 |
| Wyoming | $72.83 | $72.83 |
| South Carolina | $72.49 | $72.49 |
| Kentucky | $72.42 | $72.42 |
| Virginia | $72.39 | $72.39 |
| Oklahoma | $71.60 | $71.60 |
| Maine | $71.51 | $71.51 |
| North Carolina | $71.28 | $71.28 |
| Vermont | $71.21 | $71.21 |
| Mississippi | $70.92 | $70.92 |
| North Dakota | $70.71 | $70.71 |
| Minnesota | $70.41 | $70.41 |
| Tennessee | $70.30 | $70.30 |
| South Dakota | $70.27 | $70.27 |
| Indiana | $70.22 | $70.22 |
| Idaho | $70.04 | $70.04 |
| Alabama | $70.02 | $70.02 |
| Kansas | $70.02 | $70.02 |
| Wisconsin | $69.52 | $69.52 |
| Iowa | $69.49 | $69.49 |
| Arkansas | $69.48 | $69.48 |
| Nebraska | $69.48 | $69.48 |

## Related codes

- 99222: Initial hospital inpatient or observation care, moderate medical decision making — https://www.med-reveal.com/rates/99222-cpt-fee-schedule
- 99223: Initial hospital inpatient or observation care, high medical decision making — https://www.med-reveal.com/rates/99223-cpt-fee-schedule
- 99231: Subsequent hospital inpatient or observation care, straightforward to low medical decision making — https://www.med-reveal.com/rates/99231-cpt-fee-schedule
- 99232: Subsequent hospital inpatient or observation care, moderate medical decision making — https://www.med-reveal.com/rates/99232-cpt-fee-schedule
- 99233: Subsequent hospital inpatient or observation care, high medical decision making — https://www.med-reveal.com/rates/99233-cpt-fee-schedule
- 99238: Hospital inpatient or observation discharge day management, 30 minutes or less — https://www.med-reveal.com/rates/99238-cpt-fee-schedule
- 99239: Hospital inpatient or observation discharge day management, more than 30 minutes — https://www.med-reveal.com/rates/99239-cpt-fee-schedule

Commercial negotiated rates for 99221 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules