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Same-Day Hospital Admission And Discharge, Moderate

Virginia 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 $302 · 10th–90th $120$9550%10%10th90th$302Professionalmedian $182 · 10th–90th $141$3020%10%20%10th90th$182$100.0$200.0$500.0$1.0K$2.0K$5.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$309.03
Typical High
$954.99
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$794.33
Typical High
$977.24
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$177.83
Typical High
$549.54
Medcost
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$245.47
Typical High
$302.00
Medcost
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$223.87
Typical High
$338.84
Sentara
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$213.80
Typical High
$794.33
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78