# CPT 99231: Subsequent hospital inpatient or observation care, straightforward to low medical decision making

Medicare CPT 99231 pays $44.09 in a non-facility setting and $44.09 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $41.66 in Arkansas to $60.11 in Alaska, a 44% spread.

Web page: https://www.med-reveal.com/rates/99231-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation, General Acute Care Hospital, Hematology & Oncology, Infectious Disease, Internal Medicine, Neurological Surgery, Neurology, Ophthalmology, Plastic Surgery, Psychiatry & Neurology, Pulmonary Disease, Thoracic Surgery (Cardiothoracic Vascular Surgery), Vascular Surgery

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $44.09 |
| National facility | $44.09 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $60.11 | $60.11 |
| District of Columbia | $47.62 | $47.62 |
| New York | $47.56 | $47.56 |
| New Jersey | $47.04 | $47.04 |
| Florida | $46.64 | $46.64 |
| Illinois | $46.37 | $46.37 |
| Connecticut | $45.94 | $45.94 |
| Washington | $45.70 | $45.70 |
| Massachusetts | $45.61 | $45.61 |
| California | $45.53 | $45.53 |
| Maryland | $45.07 | $45.07 |
| Rhode Island | $44.70 | $44.70 |
| Michigan | $44.69 | $44.69 |
| Colorado | $44.42 | $44.42 |
| Pennsylvania | $44.41 | $44.41 |
| Georgia | $44.30 | $44.30 |
| West Virginia | $44.19 | $44.19 |
| Puerto Rico | $44.14 | $44.14 |
| Virgin Islands | $44.14 | $44.14 |
| Montana | $44.08 | $44.08 |
| New Hampshire | $44.08 | $44.08 |
| Hawaii | $44.06 | $44.06 |
| Oregon | $44.05 | $44.05 |
| New Mexico | $43.96 | $43.96 |
| Texas | $43.96 | $43.96 |
| Delaware | $43.89 | $43.89 |
| Nevada | $43.65 | $43.65 |
| Louisiana | $43.52 | $43.52 |
| Arizona | $43.46 | $43.46 |
| Ohio | $43.41 | $43.41 |
| Missouri | $43.39 | $43.39 |
| Wyoming | $43.39 | $43.39 |
| Utah | $43.34 | $43.34 |
| Virginia | $43.17 | $43.17 |
| South Carolina | $43.08 | $43.08 |
| Kentucky | $42.97 | $42.97 |
| Maine | $42.74 | $42.74 |
| Vermont | $42.69 | $42.69 |
| Oklahoma | $42.64 | $42.64 |
| North Carolina | $42.59 | $42.59 |
| North Dakota | $42.50 | $42.50 |
| Minnesota | $42.44 | $42.44 |
| South Dakota | $42.31 | $42.31 |
| Mississippi | $42.28 | $42.28 |
| Indiana | $42.13 | $42.13 |
| Tennessee | $42.12 | $42.12 |
| Idaho | $42.04 | $42.04 |
| Kansas | $41.99 | $41.99 |
| Alabama | $41.93 | $41.93 |
| Wisconsin | $41.90 | $41.90 |
| Nebraska | $41.81 | $41.81 |
| Iowa | $41.80 | $41.80 |
| Arkansas | $41.66 | $41.66 |

## 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
- 99223: Initial hospital inpatient or observation care, high medical decision making — https://www.med-reveal.com/rates/99223-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 99231 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