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New York rates for HCPCS 99233

Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 50 minutes must be met or exceeded.

Facilitymedian $129 · 10th–90th $83–$2340%20%10th90th$129Professionalmedian $117 · 10th–90th $71–$2950%20%10th90th$117$1.0$10.0$100.0$1.0K$10.0K

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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $128.82 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $117.49 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $109.65 / $194.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $79.43 / $229.09
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $181.97 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $147.91 / $354.81
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $120.23 / $275.42
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $120.23 / $199.53
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $123.03 / $218.78
Fidelis
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $131.83 / $288.40
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $144.54 / $239.88
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $112.20 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $109.65 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $147.91 / $234.42
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $97.72 / $275.42
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $125.89 / $302.00