Cost analysis for CPT 99223 — Initial hospital inpatient care, typically 70 minutes per day
Average Medicare Payment
$132.98
2023 data
Total Payments (2023)
$1.3B
Services (2023)
9.5M
Price Change (2014–2023)
-15.4%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $157.12 | $1.7B | 10.6M | — |
| 2015 | $157.37 | $1.7B | 10.5M | +0.2% |
| 2016 | $155.69 | $1.6B | 10.4M | -1.1% |
| 2017 | $156.28 | $1.6B | 10.3M | +0.4% |
| 2018 | $157.03 | $1.6B | 10.2M | +0.5% |
| 2019 | $158.14 | $1.6B | 10.2M | +0.7% |
| 2020 | $160.79 | $1.5B | 9.1M | +1.7% |
| 2021 | $157.21 | $1.4B | 8.8M | -2.2% |
| 2022 | $153.00 | $1.3B | 8.4M | -2.7% |
| 2023 | $132.98 | $1.3B | 9.5M | -13.1% |
The most expensive state pays 1.4x more than the cheapest for this procedure. AK averages $174.37 vs NE at $123.09.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $174.37 | $1.9M | 11.0K | 202 |
| NY | $147.01 | $80.4M | 546.8K | 8.7K |
| DC | $142.99 | $5.1M | 35.8K | 613 |
| NJ | $142.50 | $58.9M | 413.4K | 5.0K |
| CA | $141.78 | $149.0M | 1.1M | 13.2K |
| AE | $141.52 | $14.6K | 103 | 2 |
| CT | $139.38 | $12.0M | 86.1K | 1.7K |
| MA | $137.76 | $33.6M | 243.8K | 4.4K |
| AP | $137.71 | $34.6K | 251 | 5 |
| IL | $136.95 | $64.6M | 471.6K | 6.2K |
| MD | $136.68 | $30.2M | 220.7K | 2.9K |
| FL | $134.45 | $138.6M | 1.0M | 11.1K |
| RI | $134.33 | $3.4M | 25.6K | 535 |
| DE | $134.22 | $5.3M | 39.1K | 503 |
| MI | $134.14 | $40.7M | 303.5K | 4.9K |
| WA | $133.57 | $16.4M | 123.1K | 2.6K |
| VA | $132.64 | $33.7M | 254.3K | 3.7K |
| CO | $132.35 | $12.7M | 95.7K | 1.9K |
| PA | $132.06 | $54.6M | 413.3K | 7.0K |
| HI | $131.94 | $2.3M | 17.6K | 336 |
| PR | $131.86 | $975.1K | 7.4K | 199 |
| NV | $131.62 | $17.5M | 132.8K | 1.3K |
| MT | $131.61 | $2.9M | 21.9K | 413 |
| NH | $131.49 | $5.1M | 38.4K | 700 |
| GU | $131.21 | $146.6K | 1.1K | 21 |
| ND | $130.69 | $2.9M | 22.1K | 325 |
| OR | $130.16 | $8.0M | 61.7K | 1.4K |
| AZ | $130.09 | $30.3M | 233.2K | 2.8K |
| TX | $130.04 | $94.8M | 729.3K | 10.0K |
| ME | $129.97 | $3.2M | 24.5K | 595 |
| GA | $129.54 | $32.3M | 249.2K | 4.0K |
| MO | $129.10 | $22.2M | 172.0K | 2.7K |
| VT | $129.10 | $1.4M | 10.7K | 233 |
| ZZ | $129.09 | $53.7K | 416 | 7 |
| WV | $128.80 | $6.2M | 47.9K | 781 |
| OH | $128.76 | $42.3M | 328.2K | 5.6K |
| NM | $128.35 | $3.5M | 27.5K | 486 |
| WY | $128.30 | $1.0M | 8.1K | 132 |
| MN | $128.26 | $11.7M | 91.1K | 2.4K |
| SD | $128.02 | $2.5M | 19.6K | 335 |
| LA | $128.00 | $18.0M | 140.9K | 2.3K |
| UT | $127.23 | $3.8M | 29.5K | 763 |
| SC | $127.13 | $17.3M | 136.4K | 2.1K |
| KY | $126.40 | $16.7M | 132.0K | 1.9K |
| OK | $126.38 | $14.8M | 117.0K | 1.5K |
| WI | $126.12 | $12.7M | 100.4K | 2.1K |
| KS | $125.91 | $10.9M | 86.8K | 1.2K |
| NC | $125.90 | $29.9M | 237.5K | 4.6K |
| AL | $125.54 | $17.3M | 137.8K | 2.1K |
| ID | $125.45 | $3.3M | 26.2K | 499 |
| IN | $125.15 | $25.4M | 202.8K | 3.1K |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Richard Baker | Internal Medicine | IL | $538.7K | 4.0K | $135.19 |
| Satya Chelamkuri | Family Practice | CA | $283.4K | 1.8K | $156.77 |
| Ghulam Anwar | Family Practice | FL | $213.6K | 1.6K | $130.27 |
| Mordo Suchov | Gastroenterology | CA | $205.5K | 1.4K | $144.59 |
| Yaser Daramna | Internal Medicine | NJ | $201.9K | 1.4K | $144.55 |
| Jacob Ahdoot | Nephrology | CA | $197.2K | 1.3K | $155.36 |
| Babadele Oyedepo | Hospitalist | IL | $193.8K | 1.5K | $128.46 |
| Sophia Kangarlu | Internal Medicine | CA | $192.9K | 1.3K | $144.73 |
| Philip Cassar | Gastroenterology | NY | $187.6K | 1.2K | $158.05 |
| Ravinder Singh | Neurology | CA | $184.9K | 1.3K | $144.20 |
| Fouad Bou Harb | Infectious Disease | NY | $176.8K | 1.1K | $159.74 |
| Reza Bagherpour | Physical Medicine and Rehabilitation | CA | $175.6K | 1.3K | $138.38 |
| Neiveen Peter | Internal Medicine | CA | $175.3K | 1.2K | $143.13 |
| Sumit Bhutani | Infectious Disease | MD | $172.6K | 1.2K | $139.30 |
| Danny Farah | Internal Medicine | CA | $170.9K | 1.2K | $144.72 |
| Mustafa Al Lami | Hospitalist | CA | $169.7K | 1.2K | $136.32 |
| Sam Kalioundji | Cardiology | CA | $169.5K | 1.1K | $148.14 |
| Swati Joglekar | Internal Medicine | TX | $167.2K | 1.2K | $136.80 |
| Gurdarshan Sandhu | Internal Medicine | NJ | $166.1K | 1.1K | $145.99 |
| Lutfi Sayyur | Internal Medicine | CA | $165.4K | 1.2K | $139.69 |
Based on the data, CPT 99223 shows a 1.4x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 15.4% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.