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Procedure price report

First day of observation care, high complexity

CPT 99220the billing code this page is about

The clinician's first-day assessment of a patient placed in hospital observation status for a complex or severe problem; billed once for that day. This code was retired after 2022.

Hospitals typically charge $273 cash for this outpatient procedure — the median across 286 hospitals that filed a usable cash price; the average of the middle 60% is $285. Most fall between $161 and $460 (20th–80th percentile).

Hospitals
286
States
45
Filings dated
Mar 2023 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 24, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 286 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$113$183$273$411$609

The most expensive tenth of hospitals charges at least 5.4× what the cheapest tenth charges ($113 vs $609).

How the prices are spread

$76 – $96: 10 hospitals$76$96 – $119: 7 hospitals$119 – $149: 11 hospitals$119$149 – $187: 31 hospitals$187 – $233: 41 hospitals$187$233 – $292: 35 hospitals$292 – $364: 42 hospitals$292$364 – $456: 37 hospitals$456 – $569: 22 hospitals$456$569 – $712: 22 hospitals$569median $273price bands are equal on a log scale
Hospitals per price band (258 of 286 — the bands cover the 5th to 95th percentile)
FromToHospitals
$76$9610
$96$1197
$119$14911
$149$18731
$187$23341
$233$29235
$292$36442
$364$45637
$456$56922
$569$71222

By state

The median cash price in each state, against the national median of $273.

Alaska: 3 hospitals filed a usable price — fewer than 10, so no figureAKMaine: 5 hospitals filed a usable price — fewer than 10, so no figureMEVermont: 2 hospitals filed a usable price — fewer than 10, so no figureVTNew Hampshire: no hospital in the corpus filed a usable priceNHWashington: 5 hospitals filed a usable price — fewer than 10, so no figureWAIdaho: 2 hospitals filed a usable price — fewer than 10, so no figureIDMontana: 2 hospitals filed a usable price — fewer than 10, so no figureMTNorth Dakota: 6 hospitals filed a usable price — fewer than 10, so no figureNDMinnesota: 5 hospitals filed a usable price — fewer than 10, so no figureMNIllinois: median $310 across 19 hospitalsIL$310Wisconsin: 8 hospitals filed a usable price — fewer than 10, so no figureWIMichigan: median $230 across 17 hospitalsMI$230New York: median $143 across 12 hospitalsNY$143Massachusetts: 1 hospital filed a usable price — fewer than 10, so no figureMAOregon: median $496 across 13 hospitalsOR$496Nevada: 2 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 4 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: 1 hospital filed a usable price — fewer than 10, so no figureSDIowa: median $299 across 21 hospitalsIA$299Indiana: median $149 across 14 hospitalsIN$149Ohio: 8 hospitals filed a usable price — fewer than 10, so no figureOHPennsylvania: 3 hospitals filed a usable price — fewer than 10, so no figurePANew Jersey: 1 hospital filed a usable price — fewer than 10, so no figureNJConnecticut: no hospital in the corpus filed a usable priceCTRhode Island: 2 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $663 across 16 hospitalsCA$663Utah: 2 hospitals filed a usable price — fewer than 10, so no figureUTColorado: 6 hospitals filed a usable price — fewer than 10, so no figureCONebraska: 6 hospitals filed a usable price — fewer than 10, so no figureNEMissouri: 8 hospitals filed a usable price — fewer than 10, so no figureMOKentucky: 9 hospitals filed a usable price — fewer than 10, so no figureKYWest Virginia: 3 hospitals filed a usable price — fewer than 10, so no figureWVVirginia: no hospital in the corpus filed a usable priceVAMaryland: no hospital in the corpus filed a usable priceMDDelaware: no hospital in the corpus filed a usable priceDEArizona: 7 hospitals filed a usable price — fewer than 10, so no figureAZNew Mexico: 1 hospital filed a usable price — fewer than 10, so no figureNMKansas: 8 hospitals filed a usable price — fewer than 10, so no figureKSArkansas: 5 hospitals filed a usable price — fewer than 10, so no figureARTennessee: 9 hospitals filed a usable price — fewer than 10, so no figureTNNorth Carolina: 3 hospitals filed a usable price — fewer than 10, so no figureNCSouth Carolina: 2 hospitals filed a usable price — fewer than 10, so no figureSCOklahoma: median $194 across 13 hospitalsOK$194Louisiana: 2 hospitals filed a usable price — fewer than 10, so no figureLAMississippi: 5 hospitals filed a usable price — fewer than 10, so no figureMSAlabama: 5 hospitals filed a usable price — fewer than 10, so no figureALGeorgia: 8 hospitals filed a usable price — fewer than 10, so no figureGAHawaii: 1 hospital filed a usable price — fewer than 10, so no figureHITexas: 6 hospitals filed a usable price — fewer than 10, so no figureTXFlorida: 5 hospitals filed a usable price — fewer than 10, so no figureFL
Cash price by state, most expensive first. National median $273. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
California CA16$663+143%$75 – $705
Oregon OR13$496+82%$308 – $609
Illinois IL19$310+14%$149 – $513
Iowa IA21$299+10%$241 – $386
Michigan MI17$230−16%$134 – $233
Oklahoma OK13$194−29%$194 – $194
Indiana IN14$149−45%$95 – $370
New York NY12$143−48%$83 – $292
Kentucky KY9not enough hospitals filed a usable price
Tennessee TN9not enough hospitals filed a usable price
Georgia GA8not enough hospitals filed a usable price
Kansas KS8not enough hospitals filed a usable price
Missouri MO8not enough hospitals filed a usable price
Ohio OH8not enough hospitals filed a usable price
Wisconsin WI8not enough hospitals filed a usable price
Arizona AZ7not enough hospitals filed a usable price
Colorado CO6not enough hospitals filed a usable price
North Dakota ND6not enough hospitals filed a usable price
Nebraska NE6not enough hospitals filed a usable price
Texas TX6not enough hospitals filed a usable price
Alabama AL5not enough hospitals filed a usable price
Arkansas AR5not enough hospitals filed a usable price
Florida FL5not enough hospitals filed a usable price
Maine ME5not enough hospitals filed a usable price
Minnesota MN5not enough hospitals filed a usable price
Mississippi MS5not enough hospitals filed a usable price
Washington WA5not enough hospitals filed a usable price
Wyoming WY4not enough hospitals filed a usable price
Alaska AK3not enough hospitals filed a usable price
North Carolina NC3not enough hospitals filed a usable price
Pennsylvania PA3not enough hospitals filed a usable price
West Virginia WV3not enough hospitals filed a usable price
Idaho ID2not enough hospitals filed a usable price
Louisiana LA2not enough hospitals filed a usable price
Montana MT2not enough hospitals filed a usable price
Nevada NV2not enough hospitals filed a usable price
Rhode Island RI2not enough hospitals filed a usable price
South Carolina SC2not enough hospitals filed a usable price
Utah UT2not enough hospitals filed a usable price
Vermont VT2not enough hospitals filed a usable price
Hawaii HI1not enough hospitals filed a usable price
Massachusetts MA1not enough hospitals filed a usable price
New Jersey NJ1not enough hospitals filed a usable price
New Mexico NM1not enough hospitals filed a usable price
South Dakota SD1not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $273.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care129$245$149 – $450
Children’s6fewer than 20 hospitals
Critical access150$294$164 – $451
Ownership
For-profit25$161$95 – $598
Government87$294$183 – $418
Non-profit173$275$163 – $467
System affiliation
Part of a system182$242$149 – $428
Independent104$295$195 – $496

Cash price vs list price

Median list price (chargemaster)$409
Median cash price$273
Cash as a share of list, median hospital70%

At the typical hospital, asking for the cash price cuts the list price by about 30%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

168 hospitals filed a usable inpatient cash price for this code. The median is $246 and the average of the middle 60% is $258; most fall between $149 and $425.

Cash price percentiles, inpatient, across 168 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$127$164$246$369$663

The most expensive tenth of hospitals charges at least 5.2× what the cheapest tenth charges ($127 vs $663).

Of the 185 hospitals that filed this code inpatient, 168 gave a usable cash price; 2 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 15 a list price only.

How complete is this

286 of the 3,956 hospitals with a price file in our corpus (7%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 312 hospitals that filed this code at all gave us
Usable cash price — counted286
Cash price carrying a plausibility flag — shown on the compare tool, excluded here7
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded0
A list price only, no cash figure — excluded19
Hospitals that filed this code312

Sections not shown for this setting

  • Against Medicare: Medicare has no separately payable national outpatient (OPPS) rate for this code, so there is nothing honest to compare against.
  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between September 4, 2026 and September 24, 2026; the figures were computed September 25, 2026 from filings loaded through September 24, 2026. The percentiles and averages use only the “counted” row.

Hospitals file this code under descriptions such as Other Pro.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “First day of observation care, high complexity (CPT 99220) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-99220-first-day-of-observation-care-high-complexity