# CPT 99235: Hospital inpatient or observation care, same date admission and discharge, moderate medical decision making

Medicare 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.

Web page: https://www.med-reveal.com/rates/99235-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation, Pain Medicine

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $142.96 |
| National facility | $142.96 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| 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 | $142.93 | $142.93 |
| 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 | $138.67 | $138.67 |
| 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 |

## Related codes

- 99234: Hospital inpatient or observation care, same date admission and discharge, straightforward to low medical decision making — https://www.med-reveal.com/rates/99234-cpt-fee-schedule
- 99236: Hospital inpatient or observation care, same date admission and discharge, high medical decision making — https://www.med-reveal.com/rates/99236-cpt-fee-schedule
- G0463: Hospital outpatient clinic visit for assessment and management of a patient — https://www.med-reveal.com/rates/G0463-hcpcs-fee-schedule

Commercial negotiated rates for 99235 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