# CPT 99238: Hospital inpatient or observation discharge day management, 30 minutes or less

Medicare CPT 99238 pays $74.82 in a non-facility setting and $74.82 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $69.95 in Arkansas to $99.42 in Alaska, a 42% spread.

Web page: https://www.med-reveal.com/rates/99238-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation, General Acute Care Hospital, General Surgery, Hematology & Oncology, Infectious Disease, Internal Medicine, Neurology, Ophthalmology, Orthopaedic Surgery, Plastic Surgery, Psychiatry & Neurology, Pulmonary Disease, Thoracic Surgery (Cardiothoracic Vascular Surgery)

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $74.82 |
| National facility | $74.82 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $99.42 | $99.42 |
| District of Columbia | $81.66 | $81.66 |
| New York | $81.03 | $81.03 |
| New Jersey | $80.34 | $80.34 |
| Florida | $78.68 | $78.68 |
| California | $78.57 | $78.57 |
| Washington | $78.45 | $78.45 |
| Connecticut | $78.26 | $78.26 |
| Massachusetts | $78.18 | $78.18 |
| Illinois | $77.94 | $77.94 |
| Maryland | $76.66 | $76.66 |
| Rhode Island | $76.02 | $76.02 |
| Hawaii | $75.97 | $75.97 |
| Colorado | $75.87 | $75.87 |
| Oregon | $75.22 | $75.22 |
| Michigan | $75.19 | $75.19 |
| New Hampshire | $75.17 | $75.17 |
| Pennsylvania | $75.12 | $75.12 |
| Puerto Rico | $74.99 | $74.99 |
| Virgin Islands | $74.99 | $74.99 |
| Montana | $74.81 | $74.81 |
| Georgia | $74.73 | $74.73 |
| Texas | $74.49 | $74.49 |
| Delaware | $74.42 | $74.42 |
| Nevada | $74.17 | $74.17 |
| New Mexico | $73.90 | $73.90 |
| West Virginia | $73.83 | $73.83 |
| Wyoming | $73.78 | $73.78 |
| Arizona | $73.60 | $73.60 |
| Virginia | $73.29 | $73.29 |
| Louisiana | $73.21 | $73.21 |
| Utah | $73.17 | $73.17 |
| Missouri | $73.05 | $73.05 |
| Ohio | $73.05 | $73.05 |
| South Carolina | $72.64 | $72.64 |
| Vermont | $72.63 | $72.63 |
| Minnesota | $72.60 | $72.60 |
| North Dakota | $72.44 | $72.44 |
| Maine | $72.40 | $72.40 |
| Kentucky | $72.18 | $72.18 |
| South Dakota | $72.16 | $72.16 |
| North Carolina | $71.98 | $71.98 |
| Oklahoma | $71.71 | $71.71 |
| Indiana | $71.25 | $71.25 |
| Wisconsin | $71.17 | $71.17 |
| Tennessee | $71.08 | $71.08 |
| Idaho | $71.05 | $71.05 |
| Mississippi | $70.89 | $70.89 |
| Kansas | $70.84 | $70.84 |
| Nebraska | $70.73 | $70.73 |
| Iowa | $70.64 | $70.64 |
| Alabama | $70.49 | $70.49 |
| Arkansas | $69.95 | $69.95 |

## 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
- 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
- 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 99238 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