CPT 99235

Hospital Ip/Obs Care Same Date Mod Mdm 70 Min

CPT 99235 pays $142.96 in a non-facility setting and $142.96 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $135.19 in Arkansas to $195.03 in Alaska, a 44% spread.

National non-facility rate

$142.96

Office and other outpatient settings

Facility rate
$142.96

Hospital and ASC settings

Highest state
$195.03

Alaska

Lowest state
$135.19

Arkansas · 44% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $142.96
CPT 99235 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $142.96, national facility $142.96.
StateRate compared visuallyNon-facilityFacility
Alaska
$195.03$195.03
District of Columbia
$154.44$154.44
New York
$154.14$154.14
New Jersey
$152.54$152.54
Florida
$150.95$150.95
Illinois
$150.05$150.05
Connecticut
$148.91$148.91
Washington
$148.30$148.30
Massachusetts
$147.99$147.99
California
$147.85$147.85
Maryland
$146.13$146.13
Rhode Island
$144.98$144.98
Michigan
$144.75$144.75
Colorado
$144.11$144.11
Pennsylvania
$143.97$143.97
Georgia
$143.55$143.55
Puerto Rico
$143.12$143.12
Virgin Islands
$143.12$143.12
West Virginia
$143.10$143.10
Hawaii
$143.06$143.06
New Hampshire
$142.99$142.99
Montana
$142.94$142.94
Oregon
$142.92$142.92
Texas
$142.55$142.55
New Mexico
$142.44$142.44
Delaware
$142.34$142.34
Nevada
$141.59$141.59
Louisiana
$141.05$141.05
Arizona
$140.94$140.94
Wyoming
$140.78$140.78
Ohio
$140.73$140.73
Missouri
$140.65$140.65
Utah
$140.52$140.52
Virginia
$140.05$140.05
South Carolina
$139.70$139.70
Kentucky
$139.32$139.32
Maine
$138.66$138.66
Vermont
$138.57$138.57
Oklahoma
$138.27$138.27
North Carolina
$138.17$138.17
North Dakota
$138.00$138.00
Minnesota
$137.84$137.84
South Dakota
$137.41$137.41
Mississippi
$137.11$137.11
Indiana
$136.74$136.74
Tennessee
$136.69$136.69
Idaho
$136.44$136.44
Kansas
$136.28$136.28
Wisconsin
$136.07$136.07
Alabama
$136.03$136.03
Nebraska
$135.73$135.73
Iowa
$135.68$135.68
Arkansas
$135.19$135.19

Billed by 2 specialties

Commercial rates for 99235

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates