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Observation Follow-Up Visit, High Complexity

Nationwide rates for HCPCS 99226

A follow-up visit by the doctor to a patient under observation in hospital whose condition is unstable or has worsened. It covers a detailed reassessment, a full review of new findings, and complex decisions about changing treatment or moving to a full admission.

Rates data updated July 2026.

Facilitymedian $257 · 10th–90th $110$7590%20%10th90th$257Professionalmedian $200 · 10th–90th $87$3980%10%10th90th$200$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$338.84
Typical High
$954.99
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$239.88
Typical High
$407.38
United
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$223.87
Typical High
$870.96
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$87.10
Typical High
$147.91