CPT 99236

Hospital Ip/Obs Care Same Date High Mdm 85 Min

CPT 99236 pays $189.72 in a non-facility setting and $189.72 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $179.08 in Arkansas to $258.34 in Alaska, a 44% spread.

National non-facility rate

$189.72

Office and other outpatient settings

Facility rate
$189.72

Hospital and ASC settings

Highest state
$258.34

Alaska

Lowest state
$179.08

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 $189.72
CPT 99236 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $189.72, national facility $189.72.
StateRate compared visuallyNon-facilityFacility
Alaska
$258.34$258.34
District of Columbia
$204.90$204.90
New York
$204.79$204.79
New Jersey
$202.40$202.40
Florida
$201.21$201.21
Illinois
$200.02$200.02
Connecticut
$197.74$197.74
Washington
$196.47$196.47
Massachusetts
$196.14$196.14
California
$195.60$195.60
Maryland
$193.96$193.96
Michigan
$192.54$192.54
Rhode Island
$192.27$192.27
Pennsylvania
$191.14$191.14
Colorado
$190.99$190.99
Georgia
$190.73$190.73
West Virginia
$190.44$190.44
Puerto Rico
$189.91$189.91
Virgin Islands
$189.91$189.91
Montana
$189.69$189.69
New Hampshire
$189.61$189.61
Oregon
$189.36$189.36
Hawaii
$189.32$189.32
New Mexico
$189.31$189.31
Texas
$189.12$189.12
Delaware
$188.81$188.81
Nevada
$187.74$187.74
Louisiana
$187.32$187.32
Arizona
$186.93$186.93
Ohio
$186.85$186.85
Missouri
$186.72$186.72
Wyoming
$186.59$186.59
Utah
$186.45$186.45
Virginia
$185.60$185.60
South Carolina
$185.32$185.32
Kentucky
$184.91$184.91
Maine
$183.71$183.71
Vermont
$183.44$183.44
Oklahoma
$183.39$183.39
North Carolina
$183.09$183.09
North Dakota
$182.57$182.57
Minnesota
$182.24$182.24
Mississippi
$181.84$181.84
South Dakota
$181.73$181.73
Indiana
$181.05$181.05
Tennessee
$181.05$181.05
Idaho
$180.65$180.65
Kansas
$180.48$180.48
Alabama
$180.24$180.24
Wisconsin
$179.97$179.97
Nebraska
$179.61$179.61
Iowa
$179.57$179.57
Arkansas
$179.08$179.08

Billed by 2 specialties

Commercial rates for 99236

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

See negotiated rates