Cost analysis for CPT 99238 — Hospital discharge day management, 30 minutes or less
Average Medicare Payment
$61.74
2023 data
Total Payments (2023)
$93.5M
Services (2023)
1.5M
Price Change (2014–2023)
+10.8%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $55.74 | $190.7M | 3.4M | — |
| 2015 | $56.20 | $179.4M | 3.2M | +0.8% |
| 2016 | $55.34 | $165.3M | 3.0M | -1.5% |
| 2017 | $55.59 | $152.7M | 2.7M | +0.5% |
| 2018 | $56.34 | $140.3M | 2.5M | +1.3% |
| 2019 | $56.90 | $129.5M | 2.3M | +1.0% |
| 2020 | $57.73 | $99.2M | 1.7M | +1.5% |
| 2021 | $56.66 | $85.4M | 1.5M | -1.9% |
| 2022 | $55.60 | $74.9M | 1.3M | -1.9% |
| 2023 | $61.74 | $93.5M | 1.5M | +11.0% |
The most expensive state pays 1.4x more than the cheapest for this procedure. AK averages $81.83 vs AR at $57.10.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $81.83 | $267.6K | 3.3K | 79 |
| NY | $68.83 | $7.2M | 104.7K | 2.4K |
| DC | $67.25 | $216.5K | 3.2K | 106 |
| CA | $66.44 | $7.7M | 115.5K | 2.4K |
| NJ | $66.16 | $3.3M | 49.5K | 1.1K |
| AP | $65.85 | $9.4K | 143 | 2 |
| CT | $65.20 | $893.5K | 13.7K | 436 |
| MA | $64.38 | $2.6M | 40.1K | 1.2K |
| MD | $64.28 | $1.1M | 17.7K | 416 |
| IL | $63.94 | $5.0M | 77.8K | 1.7K |
| FL | $63.13 | $9.3M | 147.2K | 2.5K |
| HI | $63.12 | $101.3K | 1.6K | 45 |
| MI | $63.04 | $3.8M | 60.5K | 1.5K |
| RI | $62.87 | $421.2K | 6.7K | 217 |
| NV | $62.19 | $611.4K | 9.8K | 190 |
| WA | $62.15 | $857.0K | 13.8K | 483 |
| PA | $62.08 | $4.7M | 76.1K | 2.0K |
| DE | $61.82 | $354.3K | 5.7K | 167 |
| CO | $61.65 | $813.6K | 13.2K | 425 |
| MT | $61.59 | $347.7K | 5.6K | 171 |
| VA | $61.47 | $1.8M | 29.1K | 818 |
| GU | $61.20 | $12.6K | 206 | 7 |
| TX | $60.96 | $6.8M | 110.9K | 2.3K |
| VT | $60.72 | $191.5K | 3.2K | 79 |
| NH | $60.68 | $460.3K | 7.6K | 192 |
| OR | $60.64 | $558.3K | 9.2K | 289 |
| ME | $60.41 | $254.9K | 4.2K | 137 |
| AZ | $60.27 | $1.3M | 22.4K | 578 |
| GA | $60.25 | $2.2M | 35.8K | 873 |
| ND | $60.12 | $349.0K | 5.8K | 176 |
| NM | $59.92 | $374.5K | 6.3K | 189 |
| MO | $59.80 | $2.1M | 35.2K | 835 |
| MN | $59.75 | $759.7K | 12.7K | 511 |
| OH | $59.73 | $2.7M | 44.8K | 1.2K |
| WY | $59.70 | $228.4K | 3.8K | 98 |
| SD | $59.66 | $348.8K | 5.8K | 183 |
| PR | $59.63 | $119.8K | 2.0K | 68 |
| LA | $59.59 | $1.7M | 28.2K | 591 |
| NC | $59.44 | $1.8M | 30.4K | 925 |
| WV | $59.25 | $1.1M | 18.6K | 408 |
| SC | $59.23 | $1.3M | 21.6K | 563 |
| OK | $59.16 | $1.5M | 25.6K | 557 |
| AL | $59.15 | $1.9M | 32.4K | 720 |
| WI | $58.91 | $1.2M | 20.3K | 634 |
| KY | $58.80 | $1.6M | 26.7K | 577 |
| KS | $58.72 | $1.0M | 17.3K | 449 |
| VI | $58.64 | $11.4K | 194 | 5 |
| TN | $58.26 | $2.3M | 39.5K | 934 |
| IN | $58.25 | $2.1M | 36.1K | 897 |
| NE | $58.20 | $850.1K | 14.6K | 409 |
| UT | $57.99 | $482.6K | 8.3K | 239 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Sukhdeep Sandhu | Internal Medicine | CA | $106.8K | 1.6K | $65.05 |
| Aung Moe | Internal Medicine | CA | $106.2K | 1.6K | $65.19 |
| Alexander Dejesus | Physical Medicine and Rehabilitation | FL | $75.6K | 1.2K | $63.52 |
| Kevin Bernstein | Psychiatry | NV | $72.4K | 1.1K | $63.04 |
| Lutfi Sayyur | Internal Medicine | CA | $69.4K | 1.0K | $68.07 |
| Rajnish Puri | Internal Medicine | FL | $65.4K | 1.0K | $63.25 |
| Payam Shadi | Internal Medicine | CA | $65.0K | 930 | $69.91 |
| Deepak Wahi | Internal Medicine | CA | $62.5K | 976 | $64.00 |
| Madhavi Muppidi | Physical Medicine and Rehabilitation | TX | $55.2K | 893 | $61.82 |
| Msonthi Levine | Internal Medicine | TX | $54.7K | 887 | $61.68 |
| Rajan Kapoor | Internal Medicine | FL | $53.9K | 856 | $62.95 |
| W Lorenz | Physical Medicine and Rehabilitation | SC | $49.8K | 825 | $60.40 |
| Adam Reyburn | Internal Medicine | IL | $48.3K | 785 | $61.47 |
| Richard Baker | Internal Medicine | IL | $43.6K | 661 | $65.91 |
| Aleksandr Orlovskiy | Family Practice | NY | $42.4K | 573 | $73.94 |
| Shawnna Hampton | Internal Medicine | FL | $41.9K | 636 | $65.86 |
| Geoff Weikle | Internal Medicine | TX | $41.3K | 669 | $61.67 |
| Mhd Firas Zakaria | Internal Medicine | IL | $40.2K | 601 | $66.90 |
| Rostislav Tabak | Internal Medicine | NY | $40.0K | 544 | $73.46 |
| Robert Linden | Internal Medicine | NY | $39.4K | 548 | $71.88 |
Based on the data, CPT 99238 shows a 1.4x variation in pricing across states — relatively consistent by Medicare standards.
Costs have increased 10.8% 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.