OpenMedicare
Start Here
Explore
Fraud
Investigations
Data
Tools
About

Footer

OpenMedicare

Independent Medicare data journalism

Sister Sites

  • OpenMedicaid
  • OpenFeds
  • OpenSpending

Explore

  • Providers
  • Procedures
  • States
  • Specialties
  • Search

Fraud Analysis

  • Still Out There (AI)
  • Fraud Overview
  • Fraud Watchlist
  • Deep Dive Profiles
  • Impossible Numbers
  • Report Fraud

Investigations

  • The Algorithm Knows
  • How We Built the Model
  • Internal Medicine Crisis
  • Florida & California Fraud
  • Million Dollar Flagged
  • All Investigations

Tools

  • Provider Lookup
  • Compare
  • Cost Calculator
  • Your Medicare Dollar
  • Downloads

About

  • About OpenMedicare
  • Methodology
  • Glossary
  • Data Sources
  • API Docs
  • Updates
Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
Sister Sites: OpenMedicaid · OpenFeds · OpenSpending

© 2026 OpenMedicare. Independent data journalism. Built by TheDataProject.ai

Methodology•Download Data
  1. Home
  2. Procedures
  3. 99231
  4. Cost Analysis

How Much Does Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes Cost on Medicare?

Cost analysis for CPT 99231 — Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes

Share:

Average Medicare Payment

N/A

Total Payments (Latest)

N/A

Services (Latest)

N/A

Price Change (–)

N/A

🗺️ State-by-State Cost Variation

The most expensive state pays 1.5x more than the cheapest for this procedure. AK averages $50.47 vs ID at $34.18.

StateAvg PaymentTotal PaymentsServicesProviders
AK$50.47$480.7K9.5K135
NY$42.04$12.3M293.4K3.7K
DC$41.89$420.2K10.0K124
CA$40.45$9.3M228.8K2.6K
NJ$40.27$6.1M150.7K1.6K
MD$39.43$2.9M72.6K944
IL$39.12$5.9M150.4K2.1K
CT$38.90$2.5M63.2K1.0K
FL$38.62$11.5M296.7K3.3K
MA$38.42$6.4M165.4K1.8K
MI$38.35$5.3M137.6K2.0K
HI$38.24$199.1K5.2K88
NV$38.10$1.5M39.6K342
PA$37.70$9.4M248.2K3.0K
GU$37.46$18.8K5036
MT$37.45$525.2K14.0K241
VA$37.43$3.6M97.4K1.5K
RI$37.42$514.7K13.8K206
DE$37.40$968.3K25.9K338
PR$37.31$56.8K1.5K17
VI$37.25$27.6K7413
TX$37.19$9.4M253.6K2.7K
WA$37.13$2.2M60.2K997
NH$36.97$955.1K25.8K432
CO$36.95$994.8K26.9K503
LA$36.93$2.9M78.9K672
AZ$36.87$1.5M39.7K747
GA$36.78$3.1M83.0K1.3K
WV$36.70$1.2M33.1K457
NM$36.62$378.3K10.3K174
OR$36.48$1.2M32.0K619
MO$36.45$3.4M93.5K1.4K
ND$36.40$636.1K17.5K255
ME$36.36$539.9K14.8K308
SC$36.34$2.6M72.1K849
OH$36.15$4.6M126.9K2.3K
KY$36.14$2.8M77.5K907
VT$36.13$308.2K8.5K156
OK$36.01$1.4M40.1K514
UT$36.00$385.7K10.7K220
NC$35.78$3.2M89.4K1.5K
AL$35.73$2.6M73.5K637
WY$35.60$272.1K7.6K95
MN$35.53$1.8M50.0K1.1K
KS$35.44$1.4M40.9K594
AR$35.26$2.7M75.6K634
IN$35.23$3.1M87.3K1.3K
WI$35.20$2.0M55.7K1.1K
SD$35.13$546.1K15.5K254
TN$34.93$3.4M98.5K1.1K
IA$34.90$1.6M46.0K735

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Davinder SinghInternal MedicineCA$373.4K9.0K$41.34
Gadson JohnsonPsychiatryCA$333.3K8.1K$41.09
Bonnie DunganPhysical Medicine and RehabilitationAL$313.2K8.6K$36.34
Konstantinos KallinikosPodiatryNY$276.4K6.1K$45.42
Kevin CollinsPhysical Medicine and RehabilitationAR$211.7K5.9K$36.00
Travis HirdPhysical Medicine and RehabilitationTX$210.4K5.6K$37.38
Devin TroyerPhysical Medicine and RehabilitationSC$198.1K5.4K$36.71
Dwarakanath VuppalapatiPsychiatryNV$194.2K4.9K$39.31
Dharam GurwaraNeurologyLA$193.7K5.1K$38.22
Samir FarhatInternal MedicineNY$189.4K4.1K$45.90
W LorenzPhysical Medicine and RehabilitationSC$188.1K5.1K$37.08
Bradley ShortPhysical Medicine and RehabilitationAR$182.7K5.1K$35.50
Shoaib QureshiFamily PracticeTN$180.9K4.8K$37.49
Hiruy GessessePsychiatryCA$179.4K4.3K$41.94
Mario PachecoNurse PractitionerCA$175.5K5.0K$35.04
Darin WilbournPhysical Medicine and RehabilitationAR$163.0K4.5K$36.11
Benny GreenFamily PracticeAR$151.0K4.2K$36.30
John DisaiaPlastic and Reconstructive SurgeryCA$147.3K3.6K$41.34
Albert SydneyPsychiatryPA$145.8K3.6K$40.80
William RowePhysical Medicine and RehabilitationTX$143.0K3.8K$37.69

🤔 Is Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes Overpriced?

Based on the data, CPT 99231 shows a 1.5x variation in pricing across states — moderate variation by Medicare standards.

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.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.