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Procedure price report · Consultation, evaluation, and preventative care

First hospital or observation visit, lower complexity

CPT 99221the billing code this page is about

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.

Hospitals typically charge $168 cash for this outpatient procedure — the median across 1,255 hospitals that filed a usable cash price; the average of the middle 60% is $167. Most fall between $97 and $253 (20th–80th percentile).

Hospitals
1,255
States
50
Filings dated
Aug 2022 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 25, 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 1,255 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
$67$109$168$228$327

The most expensive tenth of hospitals charges at least 4.9× what the cheapest tenth charges ($67 vs $327).

How the prices are spread

$44 – $55: 31 hospitals$44$55 – $68: 37 hospitals$68 – $84: 62 hospitals$68$84 – $105: 99 hospitals$105 – $130: 129 hospitals$105$130 – $162: 172 hospitals$162 – $201: 224 hospitals$162$201 – $249: 181 hospitals$249 – $310: 116 hospitals$249$310 – $385: 84 hospitals$310median $168price bands are equal on a log scale
Hospitals per price band (1,135 of 1,255 — the bands cover the 5th to 95th percentile)
FromToHospitals
$44$5531
$55$6837
$68$8462
$84$10599
$105$130129
$130$162172
$162$201224
$201$249181
$249$310116
$310$38584

By state

The median cash price in each state, against the national median of $168.

Alaska: median $415 across 15 hospitalsAK$415Maine: median $166 across 23 hospitalsME$166Vermont: median $164 across 12 hospitalsVT$164New Hampshire: median $114 across 16 hospitalsNH$114Washington: median $200 across 37 hospitalsWA$200Idaho: median $192 across 11 hospitalsID$192Montana: median $215 across 26 hospitalsMT$215North Dakota: median $227 across 18 hospitalsND$227Minnesota: median $223 across 62 hospitalsMN$223Illinois: median $208 across 59 hospitalsIL$208Wisconsin: median $210 across 44 hospitalsWI$210Michigan: median $129 across 49 hospitalsMI$129New York: median $159 across 53 hospitalsNY$159Massachusetts: median $142 across 34 hospitalsMA$142Oregon: median $213 across 42 hospitalsOR$213Nevada: 7 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: median $168 across 12 hospitalsWY$168South Dakota: median $252 across 30 hospitalsSD$252Iowa: median $182 across 81 hospitalsIA$182Indiana: median $76 across 49 hospitalsIN$76Ohio: median $185 across 28 hospitalsOH$185Pennsylvania: median $78 across 30 hospitalsPA$78New Jersey: median $112 across 13 hospitalsNJ$112Connecticut: median $175 across 14 hospitalsCT$175Rhode Island: 5 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $152 across 50 hospitalsCA$152Utah: 3 hospitals filed a usable price — fewer than 10, so no figureUTColorado: median $165 across 24 hospitalsCO$165Nebraska: median $188 across 36 hospitalsNE$188Missouri: median $136 across 34 hospitalsMO$136Kentucky: median $105 across 27 hospitalsKY$105West Virginia: median $106 across 21 hospitalsWV$106Virginia: 5 hospitals filed a usable price — fewer than 10, so no figureVAMaryland: 5 hospitals filed a usable price — fewer than 10, so no figureMDDelaware: 3 hospitals filed a usable price — fewer than 10, so no figureDEArizona: 9 hospitals filed a usable price — fewer than 10, so no figureAZNew Mexico: 5 hospitals filed a usable price — fewer than 10, so no figureNMKansas: median $144 across 57 hospitalsKS$144Arkansas: median $151 across 13 hospitalsAR$151Tennessee: median $87 across 12 hospitalsTN$87North Carolina: 9 hospitals filed a usable price — fewer than 10, so no figureNCSouth Carolina: median $132 across 11 hospitalsSC$132Oklahoma: median $113 across 32 hospitalsOK$113Louisiana: 5 hospitals filed a usable price — fewer than 10, so no figureLAMississippi: median $103 across 12 hospitalsMS$103Alabama: median $103 across 17 hospitalsAL$103Georgia: median $127 across 32 hospitalsGA$127Hawaii: median $113 across 12 hospitalsHI$113Texas: median $186 across 23 hospitalsTX$186Florida: median $119 across 28 hospitalsFL$119
Cash price by state, most expensive first. National median $168. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Alaska AK15$415+147%$276 – $542
South Dakota SD30$252+50%$166 – $341
North Dakota ND18$227+35%$132 – $276
Minnesota MN62$223+33%$151 – $311
Montana MT26$215+28%$153 – $275
Oregon OR42$213+27%$150 – $309
Wisconsin WI44$210+25%$188 – $334
Illinois IL59$208+24%$127 – $286
Washington WA37$200+19%$152 – $305
Idaho ID11$192+14%$171 – $229
Nebraska NE36$188+12%$131 – $258
Texas TX23$186+11%$83 – $286
Ohio OH28$185+10%$122 – $305
Iowa IA81$182+8%$140 – $233
Connecticut CT14$175+4%$101 – $210
Wyoming WY12$1680%$155 – $272
Maine ME23$166−1%$70 – $275
Colorado CO24$165−2%$109 – $257
Vermont VT12$164−3%$144 – $247
New York NY53$159−6%$80 – $235
California CA50$152−9%$38 – $369
Arkansas AR13$151−10%$62 – $157
Kansas KS57$144−14%$110 – $200
Massachusetts MA34$142−15%$68 – $305
Missouri MO34$136−19%$93 – $168
South Carolina SC11$132−21%$82 – $181
Michigan MI49$129−23%$82 – $179
Georgia GA32$127−24%$91 – $188
Florida FL28$119−29%$13 – $346
New Hampshire NH16$114−32%$103 – $182
Hawaii HI12$113−33%$85 – $189
Oklahoma OK32$113−33%$79 – $168
New Jersey NJ13$112−33%$101 – $135
West Virginia WV21$106−37%$87 – $202
Kentucky KY27$105−37%$94 – $192
Mississippi MS12$103−39%$61 – $133
Alabama AL17$103−39%$72 – $290
Tennessee TN12$87−48%$56 – $162
Pennsylvania PA30$78−54%$53 – $175
Indiana IN49$76−55%$44 – $185
Arizona AZ9not enough hospitals filed a usable price
North Carolina NC9not enough hospitals filed a usable price
Nevada NV7not enough hospitals filed a usable price
Louisiana LA5not enough hospitals filed a usable price
Maryland MD5not enough hospitals filed a usable price
New Mexico NM5not enough hospitals filed a usable price
Rhode Island RI5not enough hospitals filed a usable price
Virginia VA5not enough hospitals filed a usable price
Delaware DE3not enough hospitals filed a usable price
Utah UT3not 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 $168.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care619$151$82 – $228
Children’s17fewer than 20 hospitals
Critical access617$182$113 – $263
Ownership
For-profit66$123$59 – $222
Government352$170$106 – $256
Non-profit835$170$98 – $252
System affiliation
Part of a system885$168$94 – $248
Independent370$169$107 – $259

Cash price vs list price

Median list price (chargemaster)$231
Median cash price$168
Cash as a share of list, median hospital74%

At the typical hospital, asking for the cash price cuts the list price by about 26%. 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

764 hospitals filed a usable inpatient cash price for this code. The median is $174 and the average of the middle 60% is $174; most fall between $99 and $256.

Cash price percentiles, inpatient, across 764 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
$76$113$174$235$328

The most expensive tenth of hospitals charges at least 4.3× what the cheapest tenth charges ($76 vs $328).

Of the 824 hospitals that filed this code inpatient, 764 gave a usable cash price; 5 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 55 a list price only.

How complete is this

1,255 of the 3,956 hospitals with a price file in our corpus (32%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 1,344 hospitals that filed this code at all gave us
Usable cash price — counted1,255
Cash price carrying a plausibility flag — shown on the compare tool, excluded here17
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 — excluded72
Hospitals that filed this code1,344

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 25, 2026; the figures were computed September 25, 2026 from filings loaded through September 25, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Consultation, evaluation, and preventative care family.

Hospitals file this code under descriptions such as 1st Hospital IP/Obs Care Sf/Low Mdm 40 Minutes.

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 hospital or observation visit, lower complexity (CPT 99221) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-99221-first-hospital-or-observation-visit-lower-complexity