{"procedure":{"code_type":"CPT","code":"99221","lay_name":"First hospital or observation visit, lower complexity","blurb":"The admitting clinician's first visit with a hospital inpatient or observation patient for a straightforward problem, about 40 minutes of care on that day; billed once per admission.","slug":"cpt-99221-first-hospital-or-observation-visit-lower-complexity","description":"1st Hospital IP/Obs Care Sf/Low Mdm 40 Minutes","name_source":"llm:claude-opus-5","name_reviewed":false,"ccs":{"code":"227","label":"Consultation, evaluation, and preventative care","surgery_flag":"n/a"}},"settings":{"outpatient":{"setting":"outpatient","computed_at":"2026-09-25T11:55:12.319193Z","corpus_loaded_through":"2026-09-25T10:46:50.712029Z","filing_date_min":"2022-09-01","filing_date_max":"2026-09-22","checked_from":"2026-09-05T02:07:09.005325Z","checked_through":"2026-09-25T10:46:52.415798Z","n_priced_setters":3956,"n_filed":1344,"n_usable":1255,"n_not_usable":0,"n_labelled":17,"n_no_cash":72,"n_estimated":0,"n_states":50,"cash_p10":66.75,"cash_p20":97.2,"cash_p25":108.5,"cash_p50":167.84,"cash_p75":228.42,"cash_p80":252.8,"cash_p90":327.0,"cash_mean_trimmed":167.44,"gross_p50":231.0,"cash_to_gross_p50":0.74,"medicare_rate":null,"medicare_schedule":null,"medicare_year":null,"cash_to_medicare_p50":null,"by_state":[{"state":"AK","n":15,"p20":276.0,"p50":414.96,"p80":542.0},{"state":"AL","n":17,"p20":72.0,"p50":102.6,"p80":290.0},{"state":"AR","n":13,"p20":61.9,"p50":151.32,"p80":157.0},{"state":"AZ","n":9,"p20":null,"p50":null,"p80":null},{"state":"CA","n":50,"p20":38.44,"p50":151.98,"p80":369.0},{"state":"CO","n":24,"p20":109.0,"p50":164.8,"p80":256.5},{"state":"CT","n":14,"p20":100.5,"p50":175.0,"p80":210.0},{"state":"DE","n":3,"p20":null,"p50":null,"p80":null},{"state":"FL","n":28,"p20":13.2,"p50":118.8,"p80":345.8},{"state":"GA","n":32,"p20":90.9,"p50":127.2,"p80":188.25},{"state":"HI","n":12,"p20":84.6,"p50":113.1,"p80":189.15},{"state":"IA","n":81,"p20":140.4,"p50":181.6,"p80":233.0},{"state":"ID","n":11,"p20":171.0,"p50":192.0,"p80":229.08},{"state":"IL","n":59,"p20":127.41,"p50":208.0,"p80":286.3},{"state":"IN","n":49,"p20":43.72,"p50":76.3,"p80":184.8},{"state":"KS","n":57,"p20":110.3,"p50":143.75,"p80":200.0},{"state":"KY","n":27,"p20":94.0,"p50":105.0,"p80":192.0},{"state":"LA","n":5,"p20":null,"p50":null,"p80":null},{"state":"MA","n":34,"p20":67.71,"p50":142.0,"p80":305.25},{"state":"MD","n":5,"p20":null,"p50":null,"p80":null},{"state":"ME","n":23,"p20":69.6,"p50":166.0,"p80":274.5},{"state":"MI","n":49,"p20":81.76,"p50":129.0,"p80":178.5},{"state":"MN","n":62,"p20":150.88,"p50":222.59,"p80":310.5},{"state":"MO","n":34,"p20":93.4,"p50":136.4,"p80":167.7},{"state":"MS","n":12,"p20":60.8,"p50":102.7,"p80":133.1},{"state":"MT","n":26,"p20":153.4,"p50":214.8,"p80":275.0},{"state":"NC","n":9,"p20":null,"p50":null,"p80":null},{"state":"ND","n":18,"p20":132.37,"p50":227.0,"p80":276.0},{"state":"NE","n":36,"p20":130.8,"p50":188.1,"p80":257.5},{"state":"NH","n":16,"p20":102.6,"p50":113.78,"p80":181.85},{"state":"NJ","n":13,"p20":100.99,"p50":111.99,"p80":135.0},{"state":"NM","n":5,"p20":null,"p50":null,"p80":null},{"state":"NV","n":7,"p20":null,"p50":null,"p80":null},{"state":"NY","n":53,"p20":80.0,"p50":158.5,"p80":235.0},{"state":"OH","n":28,"p20":121.8,"p50":185.4,"p80":305.1},{"state":"OK","n":32,"p20":79.0,"p50":112.7,"p80":167.84},{"state":"OR","n":42,"p20":149.5,"p50":212.8,"p80":309.0},{"state":"PA","n":30,"p20":53.13,"p50":78.0,"p80":175.0},{"state":"RI","n":5,"p20":null,"p50":null,"p80":null},{"state":"SC","n":11,"p20":82.0,"p50":132.0,"p80":181.2},{"state":"SD","n":30,"p20":165.87,"p50":252.25,"p80":341.0},{"state":"TN","n":12,"p20":55.5,"p50":87.44,"p80":162.4},{"state":"TX","n":23,"p20":82.62,"p50":185.85,"p80":286.3},{"state":"UT","n":3,"p20":null,"p50":null,"p80":null},{"state":"VA","n":5,"p20":null,"p50":null,"p80":null},{"state":"VT","n":12,"p20":144.0,"p50":163.63,"p80":247.27},{"state":"WA","n":37,"p20":151.9,"p50":199.5,"p80":304.8},{"state":"WI","n":44,"p20":187.99,"p50":209.95,"p80":334.22},{"state":"WV","n":21,"p20":86.5,"p50":106.11,"p80":202.0},{"state":"WY","n":12,"p20":154.75,"p50":168.48,"p80":272.0}],"by_segment":{"hospital_type":[{"key":"acute","n":619,"p20":81.76,"p50":151.0,"p80":228.42},{"key":"childrens","n":17,"p20":null,"p50":null,"p80":null},{"key":"critical_access","n":617,"p20":112.89,"p50":181.8,"p80":263.0}],"ownership":[{"key":"for_profit","n":66,"p20":58.8,"p50":122.67,"p80":222.4},{"key":"government","n":352,"p20":106.2,"p50":170.1,"p80":256.25},{"key":"nonprofit","n":835,"p20":98.0,"p50":170.0,"p80":252.0}],"affiliation":[{"key":"affiliated","n":885,"p20":93.5,"p50":167.7,"p80":248.0},{"key":"independent","n":370,"p20":106.5,"p50":168.8,"p80":258.75}]},"histogram":[{"lo":43.95,"hi":54.6,"n":31},{"lo":54.6,"hi":67.84,"n":37},{"lo":67.84,"hi":84.28,"n":62},{"lo":84.28,"hi":104.7,"n":99},{"lo":104.7,"hi":130.08,"n":129},{"lo":130.08,"hi":161.61,"n":172},{"lo":161.61,"hi":200.78,"n":224},{"lo":200.78,"hi":249.44,"n":181},{"lo":249.44,"hi":309.89,"n":116},{"lo":309.89,"hi":385.0,"n":84}],"previous":null},"inpatient":{"setting":"inpatient","computed_at":"2026-09-25T11:55:12.319193Z","corpus_loaded_through":"2026-09-25T10:46:50.712029Z","filing_date_min":"2022-09-01","filing_date_max":"2026-09-22","checked_from":"2026-09-05T02:07:09.005325Z","checked_through":"2026-09-25T10:46:52.415798Z","n_priced_setters":3956,"n_filed":824,"n_usable":764,"n_not_usable":0,"n_labelled":5,"n_no_cash":55,"n_estimated":0,"n_states":50,"cash_p10":76.3,"cash_p20":99.2,"cash_p25":112.7,"cash_p50":174.0,"cash_p75":234.72,"cash_p80":256.25,"cash_p90":328.0,"cash_mean_trimmed":173.65,"gross_p50":231.0,"cash_to_gross_p50":0.7,"medicare_rate":null,"medicare_schedule":null,"medicare_year":null,"cash_to_medicare_p50":null,"by_state":[{"state":"AK","n":4,"p20":null,"p50":null,"p80":null},{"state":"AL","n":8,"p20":null,"p50":null,"p80":null},{"state":"AR","n":8,"p20":null,"p50":null,"p80":null},{"state":"AZ","n":4,"p20":null,"p50":null,"p80":null},{"state":"CA","n":35,"p20":54.6,"p50":227.0,"p80":385.0},{"state":"CO","n":12,"p20":85.0,"p50":171.0,"p80":258.75},{"state":"CT","n":11,"p20":205.0,"p50":205.0,"p80":218.0},{"state":"DE","n":2,"p20":null,"p50":null,"p80":null},{"state":"FL","n":19,"p20":13.2,"p50":108.15,"p80":286.0},{"state":"GA","n":26,"p20":96.6,"p50":127.2,"p80":188.25},{"state":"HI","n":8,"p20":null,"p50":null,"p80":null},{"state":"IA","n":40,"p20":180.05,"p50":198.8,"p80":241.0},{"state":"ID","n":4,"p20":null,"p50":null,"p80":null},{"state":"IL","n":51,"p20":127.41,"p50":184.8,"p80":242.0},{"state":"IN","n":27,"p20":52.92,"p50":88.2,"p80":184.8},{"state":"KS","n":12,"p20":75.6,"p50":128.8,"p80":172.5},{"state":"KY","n":16,"p20":90.24,"p50":97.2,"p80":328.0},{"state":"LA","n":3,"p20":null,"p50":null,"p80":null},{"state":"MA","n":30,"p20":78.61,"p50":153.22,"p80":305.25},{"state":"MD","n":5,"p20":null,"p50":null,"p80":null},{"state":"ME","n":20,"p20":68.12,"p50":137.5,"p80":274.5},{"state":"MI","n":28,"p20":81.76,"p50":126.65,"p80":145.6},{"state":"MN","n":47,"p20":145.98,"p50":215.27,"p80":310.5},{"state":"MO","n":12,"p20":106.25,"p50":114.4,"p80":151.3},{"state":"MS","n":2,"p20":null,"p50":null,"p80":null},{"state":"MT","n":13,"p20":149.4,"p50":201.24,"p80":222.0},{"state":"NC","n":6,"p20":null,"p50":null,"p80":null},{"state":"ND","n":11,"p20":131.66,"p50":211.0,"p80":268.0},{"state":"NE","n":19,"p20":125.63,"p50":205.0,"p80":295.0},{"state":"NH","n":11,"p20":102.6,"p50":106.0,"p80":193.2},{"state":"NJ","n":7,"p20":null,"p50":null,"p80":null},{"state":"NM","n":2,"p20":null,"p50":null,"p80":null},{"state":"NV","n":5,"p20":null,"p50":null,"p80":null},{"state":"NY","n":40,"p20":97.29,"p50":181.36,"p80":252.0},{"state":"OH","n":19,"p20":101.5,"p50":161.67,"p80":223.0},{"state":"OK","n":17,"p20":112.7,"p50":112.7,"p80":139.2},{"state":"OR","n":24,"p20":149.5,"p50":215.9,"p80":327.0},{"state":"PA","n":23,"p20":78.0,"p50":140.7,"p80":210.0},{"state":"RI","n":4,"p20":null,"p50":null,"p80":null},{"state":"SC","n":7,"p20":null,"p50":null,"p80":null},{"state":"SD","n":22,"p20":165.87,"p50":215.06,"p80":359.0},{"state":"TN","n":10,"p20":55.5,"p50":122.67,"p80":162.4},{"state":"TX","n":13,"p20":172.5,"p50":196.4,"p80":286.3},{"state":"UT","n":2,"p20":null,"p50":null,"p80":null},{"state":"VA","n":4,"p20":null,"p50":null,"p80":null},{"state":"VT","n":9,"p20":null,"p50":null,"p80":null},{"state":"WA","n":17,"p20":139.7,"p50":174.24,"p80":282.0},{"state":"WI","n":27,"p20":209.95,"p50":209.95,"p80":424.8},{"state":"WV","n":12,"p20":97.2,"p50":155.92,"p80":274.0},{"state":"WY","n":6,"p20":null,"p50":null,"p80":null}],"by_segment":{"hospital_type":[{"key":"acute","n":444,"p20":88.84,"p50":156.24,"p80":241.0},{"key":"childrens","n":11,"p20":null,"p50":null,"p80":null},{"key":"critical_access","n":307,"p20":122.4,"p50":188.25,"p80":272.0}],"ownership":[{"key":"for_profit","n":54,"p20":76.3,"p50":107.8,"p80":222.4},{"key":"government","n":154,"p20":109.0,"p50":179.4,"p80":257.4},{"key":"nonprofit","n":554,"p20":102.6,"p50":180.05,"p80":259.2}],"affiliation":[{"key":"affiliated","n":577,"p20":98.38,"p50":181.36,"p80":257.6},{"key":"independent","n":187,"p20":102.6,"p50":166.5,"p80":250.0}]},"histogram":[{"lo":55.5,"hi":67.36,"n":24},{"lo":67.36,"hi":81.76,"n":39},{"lo":81.76,"hi":99.23,"n":52},{"lo":99.23,"hi":120.44,"n":65},{"lo":120.44,"hi":146.18,"n":81},{"lo":146.18,"hi":177.42,"n":90},{"lo":177.42,"hi":215.33,"n":127},{"lo":215.33,"hi":261.35,"n":102},{"lo":261.35,"hi":317.21,"n":59},{"lo":317.21,"hi":385.0,"n":55}],"previous":null}},"related":[{"code_type":"CPT","code":"99283","lay_name":"Emergency room visit, level 3 of 5","slug":"cpt-99283-emergency-room-visit-level-3-of-5"},{"code_type":"CPT","code":"99284","lay_name":"Emergency room visit, level 4 of 5","slug":"cpt-99284-emergency-room-visit-level-4-of-5"},{"code_type":"CPT","code":"99282","lay_name":"Emergency room visit, level 2 of 5","slug":"cpt-99282-emergency-room-visit-level-2-of-5"},{"code_type":"CPT","code":"99285","lay_name":"Emergency room visit, highest level","slug":"cpt-99285-emergency-room-visit-highest-level"},{"code_type":"CPT","code":"99281","lay_name":"Emergency room visit, lowest level","slug":"cpt-99281-emergency-room-visit-lowest-level"},{"code_type":"CPT","code":"99291","lay_name":"Critical care, first 30 to 74 minutes","slug":"cpt-99291-critical-care-first-30-to-74-minutes"},{"code_type":"CPT","code":"99292","lay_name":"Critical care, each additional 30 minutes","slug":"cpt-99292-critical-care-each-additional-30-minutes"},{"code_type":"CPT","code":"99211","lay_name":"Brief office visit for an existing patient (level 1)","slug":"cpt-99211-brief-office-visit-for-an-existing-patient-level-1"},{"code_type":"CPT","code":"99213","lay_name":"Office visit for an existing patient, moderate level","slug":"cpt-99213-office-visit-for-an-existing-patient-moderate-level"},{"code_type":"CPT","code":"99212","lay_name":"Short office visit for an existing patient","slug":"cpt-99212-short-office-visit-for-an-existing-patient"},{"code_type":"CPT","code":"99214","lay_name":"Office visit, established patient, moderate complexity","slug":"cpt-99214-office-visit-established-patient-moderate-complexity"},{"code_type":"CPT","code":"99215","lay_name":"Office visit, established patient, high complexity","slug":"cpt-99215-office-visit-established-patient-high-complexity"}]}