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Same-Day Hospital Admission And Discharge, Moderate

Pennsylvania rates for HCPCS 99235

Covers a doctor's evaluation and treatment of a patient who is admitted to hospital or to an observation bed and sent home on the same calendar day. It includes the history, examination, and decision-making for both the admission and the discharge. This version applies when the problem and the decisions involved are of moderate complexity.

Facilitymedian $132 · 10th–90th $126$4170%50%10th90th$132$100.0$500.0$2.0K$10.0K$50.0K

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
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$131.83
Typical High
$223.87
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$190.55
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$128.82
Typical High
$162.18
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$199.53
Typical High
$467.74