# CPT 99253: Inpatient or observation consultation, low medical decision making

Medicare CPT 99253 pays $98.87 in a non-facility setting and $98.87 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $92.97 in Arkansas to $132.29 in Alaska, a 42% spread.

Web page: https://www.med-reveal.com/rates/99253-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation, Infectious Disease, Pulmonary Disease

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $98.87 |
| National facility | $98.87 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $132.29 | $132.29 |
| District of Columbia | $107.92 | $107.92 |
| New York | $106.72 | $106.72 |
| New Jersey | $106.18 | $106.18 |
| California | $104.57 | $104.57 |
| Washington | $104.05 | $104.05 |
| Massachusetts | $103.61 | $103.61 |
| Connecticut | $103.20 | $103.20 |
| Florida | $102.76 | $102.76 |
| Illinois | $101.81 | $101.81 |
| Maryland | $101.24 | $101.24 |
| Hawaii | $101.02 | $101.02 |
| Rhode Island | $100.63 | $100.63 |
| Colorado | $100.59 | $100.59 |
| Oregon | $99.79 | $99.79 |
| New Hampshire | $99.52 | $99.52 |
| Pennsylvania | $99.17 | $99.17 |
| Puerto Rico | $99.12 | $99.12 |
| Virgin Islands | $99.12 | $99.12 |
| Montana | $98.86 | $98.86 |
| Michigan | $98.79 | $98.79 |
| Texas | $98.52 | $98.52 |
| Georgia | $98.47 | $98.47 |
| Delaware | $98.46 | $98.46 |
| Nevada | $98.23 | $98.23 |
| Wyoming | $97.82 | $97.82 |
| Arizona | $97.42 | $97.42 |
| New Mexico | $97.34 | $97.34 |
| Virginia | $97.21 | $97.21 |
| West Virginia | $96.92 | $96.92 |
| Minnesota | $96.86 | $96.86 |
| Utah | $96.77 | $96.77 |
| Louisiana | $96.62 | $96.62 |
| Vermont | $96.61 | $96.61 |
| Missouri | $96.49 | $96.49 |
| North Dakota | $96.49 | $96.49 |
| Ohio | $96.46 | $96.46 |
| South Dakota | $96.21 | $96.21 |
| Maine | $96.13 | $96.13 |
| South Carolina | $96.13 | $96.13 |
| North Carolina | $95.54 | $95.54 |
| Kentucky | $95.41 | $95.41 |
| Oklahoma | $94.97 | $94.97 |
| Wisconsin | $94.91 | $94.91 |
| Indiana | $94.76 | $94.76 |
| Idaho | $94.51 | $94.51 |
| Tennessee | $94.46 | $94.46 |
| Nebraska | $94.21 | $94.21 |
| Kansas | $94.19 | $94.19 |
| Iowa | $94.06 | $94.06 |
| Mississippi | $93.92 | $93.92 |
| Alabama | $93.62 | $93.62 |
| Arkansas | $92.97 | $92.97 |

## Related codes

- 99242: Office or outpatient consultation, low medical decision making — https://www.med-reveal.com/rates/99242-cpt-fee-schedule
- 99243: Office or outpatient consultation, moderate medical decision making (lower) — https://www.med-reveal.com/rates/99243-cpt-fee-schedule
- 99244: Office or outpatient consultation, moderate medical decision making — https://www.med-reveal.com/rates/99244-cpt-fee-schedule
- 99245: Office or outpatient consultation, high medical decision making — https://www.med-reveal.com/rates/99245-cpt-fee-schedule
- 99252: Inpatient or observation consultation, straightforward to low medical decision making — https://www.med-reveal.com/rates/99252-cpt-fee-schedule
- 99254: Inpatient or observation consultation, moderate medical decision making — https://www.med-reveal.com/rates/99254-cpt-fee-schedule
- 99255: Inpatient or observation consultation, high medical decision making — https://www.med-reveal.com/rates/99255-cpt-fee-schedule

Commercial negotiated rates for 99253 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