# CPT 99223: Initial hospital inpatient or observation care, high medical decision making

Medicare CPT 99223 pays $156.32 in a non-facility setting and $156.32 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $147.54 in Arkansas to $212.52 in Alaska, a 44% spread.

Web page: https://www.med-reveal.com/rates/99223-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation, General Acute Care Hospital, General Surgery, Hematology & Oncology, Infectious Disease, Internal Medicine, Neurological Surgery, Neurology, Orthopaedic Surgery, Plastic Surgery, Psychiatry & Neurology, Pulmonary Disease, Thoracic Surgery (Cardiothoracic Vascular Surgery), Vascular Surgery

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $156.32 |
| National facility | $156.32 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $212.52 | $212.52 |
| District of Columbia | $169.04 | $169.04 |
| New York | $168.70 | $168.70 |
| New Jersey | $166.90 | $166.90 |
| Florida | $165.27 | $165.27 |
| Illinois | $164.23 | $164.23 |
| Connecticut | $162.93 | $162.93 |
| Washington | $162.23 | $162.23 |
| Massachusetts | $161.89 | $161.89 |
| California | $161.73 | $161.73 |
| Maryland | $159.84 | $159.84 |
| Rhode Island | $158.52 | $158.52 |
| Michigan | $158.30 | $158.30 |
| Colorado | $157.59 | $157.59 |
| Pennsylvania | $157.40 | $157.40 |
| Georgia | $156.95 | $156.95 |
| Puerto Rico | $156.51 | $156.51 |
| Virgin Islands | $156.51 | $156.51 |
| Hawaii | $156.50 | $156.50 |
| West Virginia | $156.41 | $156.41 |
| New Hampshire | $156.38 | $156.38 |
| Montana | $156.30 | $156.30 |
| Oregon | $156.27 | $156.27 |
| Texas | $155.83 | $155.83 |
| New Mexico | $155.70 | $155.70 |
| Delaware | $155.60 | $155.60 |
| Nevada | $154.78 | $154.78 |
| Louisiana | $154.14 | $154.14 |
| Arizona | $154.04 | $154.04 |
| Wyoming | $153.88 | $153.88 |
| Ohio | $153.78 | $153.78 |
| Missouri | $153.69 | $153.69 |
| Utah | $153.56 | $153.56 |
| Virginia | $153.06 | $153.06 |
| South Carolina | $152.63 | $152.63 |
| Kentucky | $152.18 | $152.18 |
| Maine | $151.49 | $151.49 |
| Vermont | $151.40 | $151.40 |
| Oklahoma | $151.01 | $151.01 |
| North Carolina | $150.93 | $150.93 |
| North Dakota | $150.76 | $150.76 |
| Minnesota | $150.60 | $150.60 |
| South Dakota | $150.11 | $150.11 |
| Mississippi | $149.70 | $149.70 |
| Indiana | $149.31 | $149.31 |
| Tennessee | $149.25 | $149.25 |
| Idaho | $148.98 | $148.98 |
| Kansas | $148.79 | $148.79 |
| Wisconsin | $148.58 | $148.58 |
| Alabama | $148.50 | $148.50 |
| Nebraska | $148.18 | $148.18 |
| Iowa | $148.12 | $148.12 |
| Arkansas | $147.54 | $147.54 |

## Related codes

- 99221: Initial hospital inpatient or observation care, straightforward to low medical decision making — https://www.med-reveal.com/rates/99221-cpt-fee-schedule
- 99222: Initial hospital inpatient or observation care, moderate medical decision making — https://www.med-reveal.com/rates/99222-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 99223 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