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Procedure price report · Consultation, evaluation, and preventative care

First hospital or observation visit, high complexity

CPT 99223the billing code this page is about

The admitting clinician's first visit with a hospital inpatient or observation patient for a complex or severe problem, about 75 minutes of care on that day; billed once per admission.

Hospitals typically charge $336 cash for this outpatient procedure — the median across 1,223 hospitals that filed a usable cash price; the average of the middle 60% is $333. Most fall between $193 and $489 (20th–80th percentile).

Hospitals
1,223
States
50
Filings dated
Aug 2022 – 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 1,223 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
$141$223$336$452$604

The most expensive tenth of hospitals charges at least 4.3× what the cheapest tenth charges ($141 vs $604).

How the prices are spread

$102 – $124: 30 hospitals$102$124 – $151: 53 hospitals$151 – $184: 72 hospitals$151$184 – $223: 92 hospitals$223 – $272: 126 hospitals$223$272 – $330: 168 hospitals$330 – $401: 215 hospitals$330$401 – $488: 159 hospitals$488 – $593: 119 hospitals$488$593 – $721: 70 hospitals$593median $336price bands are equal on a log scale
Hospitals per price band (1,104 of 1,223 — the bands cover the 5th to 95th percentile)
FromToHospitals
$102$12430
$124$15153
$151$18472
$184$22392
$223$272126
$272$330168
$330$401215
$401$488159
$488$593119
$593$72170

By state

The median cash price in each state, against the national median of $336.

Alaska: median $683 across 15 hospitalsAK$683Maine: median $290 across 23 hospitalsME$290Vermont: median $310 across 12 hospitalsVT$310New Hampshire: median $254 across 15 hospitalsNH$254Washington: median $347 across 38 hospitalsWA$347Idaho: median $368 across 11 hospitalsID$368Montana: median $404 across 26 hospitalsMT$404North Dakota: median $489 across 16 hospitalsND$489Minnesota: median $445 across 64 hospitalsMN$445Illinois: median $355 across 60 hospitalsIL$355Wisconsin: median $460 across 44 hospitalsWI$460Michigan: median $267 across 44 hospitalsMI$267New York: median $332 across 52 hospitalsNY$332Massachusetts: median $368 across 15 hospitalsMA$368Oregon: median $422 across 42 hospitalsOR$422Nevada: 8 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: median $335 across 12 hospitalsWY$335South Dakota: median $503 across 31 hospitalsSD$503Iowa: median $362 across 80 hospitalsIA$362Indiana: median $188 across 40 hospitalsIN$188Ohio: median $343 across 32 hospitalsOH$343Pennsylvania: median $226 across 31 hospitalsPA$226New Jersey: 9 hospitals filed a usable price — fewer than 10, so no figureNJConnecticut: median $368 across 15 hospitalsCT$368Rhode Island: 5 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $368 across 42 hospitalsCA$368Utah: 3 hospitals filed a usable price — fewer than 10, so no figureUTColorado: median $330 across 24 hospitalsCO$330Nebraska: median $378 across 38 hospitalsNE$378Missouri: median $278 across 29 hospitalsMO$278Kentucky: median $195 across 27 hospitalsKY$195West Virginia: median $227 across 21 hospitalsWV$227Virginia: 6 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: median $530 across 10 hospitalsAZ$530New Mexico: 6 hospitals filed a usable price — fewer than 10, so no figureNMKansas: median $281 across 52 hospitalsKS$281Arkansas: median $239 across 11 hospitalsAR$239Tennessee: median $185 across 20 hospitalsTN$185North Carolina: 9 hospitals filed a usable price — fewer than 10, so no figureNCSouth Carolina: median $264 across 11 hospitalsSC$264Oklahoma: median $236 across 31 hospitalsOK$236Louisiana: median $109 across 11 hospitalsLA$109Mississippi: median $184 across 19 hospitalsMS$184Alabama: median $174 across 16 hospitalsAL$174Georgia: median $214 across 31 hospitalsGA$214Hawaii: 8 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $321 across 23 hospitalsTX$321Florida: median $207 across 27 hospitalsFL$207
Cash price by state, most expensive first. National median $336. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Alaska AK15$683+103%$454 – $1,049
Arizona AZ10$530+58%$217 – $1,170
South Dakota SD31$503+50%$340 – $601
North Dakota ND16$489+46%$303 – $550
Wisconsin WI44$460+37%$385 – $592
Minnesota MN64$445+32%$296 – $604
Oregon OR42$422+25%$314 – $578
Montana MT26$404+20%$285 – $496
Nebraska NE38$378+13%$302 – $473
Connecticut CT15$368+10%$210 – $425
Idaho ID11$368+10%$317 – $439
Massachusetts MA15$368+10%$195 – $459
California CA42$368+9%$118 – $771
Iowa IA80$362+8%$277 – $441
Illinois IL60$355+6%$164 – $571
Washington WA38$347+3%$307 – $547
Ohio OH32$343+2%$231 – $487
Wyoming WY12$3350%$279 – $501
New York NY52$332−1%$165 – $515
Colorado CO24$330−2%$238 – $414
Texas TX23$321−4%$171 – $512
Vermont VT12$310−8%$277 – $514
Maine ME23$290−14%$133 – $528
Kansas KS52$281−16%$230 – $356
Missouri MO29$278−17%$190 – $326
Michigan MI44$267−21%$63 – $338
South Carolina SC11$264−22%$168 – $298
New Hampshire NH15$254−24%$220 – $340
Arkansas AR11$239−29%$123 – $304
Oklahoma OK31$236−30%$183 – $315
West Virginia WV21$227−33%$189 – $426
Pennsylvania PA31$226−33%$107 – $368
Georgia GA31$214−36%$180 – $392
Florida FL27$207−38%$26 – $563
Kentucky KY27$195−42%$178 – $383
Indiana IN40$188−44%$145 – $368
Tennessee TN20$185−45%$142 – $244
Mississippi MS19$184−45%$124 – $293
Alabama AL16$174−48%$170 – $583
Louisiana LA11$109−68%$62 – $398
North Carolina NC9not enough hospitals filed a usable price
New Jersey NJ9not enough hospitals filed a usable price
Hawaii HI8not enough hospitals filed a usable price
Nevada NV8not enough hospitals filed a usable price
New Mexico NM6not enough hospitals filed a usable price
Virginia VA6not enough hospitals filed a usable price
Maryland MD5not enough hospitals filed a usable price
Rhode Island RI5not 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 $336.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care593$306$164 – $452
Children’s18fewer than 20 hospitals
Critical access610$351$230 – $505
Ownership
For-profit66$236$164 – $443
Government347$335$215 – $498
Non-profit808$338$195 – $488
System affiliation
Part of a system863$336$189 – $485
Independent360$332$209 – $499

Cash price vs list price

Median list price (chargemaster)$468
Median cash price$336
Cash as a share of list, median hospital71%

At the typical hospital, asking for the cash price cuts the list price by about 29%. 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

734 hospitals filed a usable inpatient cash price for this code. The median is $347 and the average of the middle 60% is $346; most fall between $198 and $492.

Cash price percentiles, inpatient, across 734 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
$151$230$347$460$615

The most expensive tenth of hospitals charges at least 4.1× what the cheapest tenth charges ($151 vs $615).

Of the 788 hospitals that filed this code inpatient, 734 gave a usable cash price; 4 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 50 a list price only.

How complete is this

1,223 of the 3,956 hospitals with a price file in our corpus (31%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 1,299 hospitals that filed this code at all gave us
Usable cash price — counted1,223
Cash price carrying a plausibility flag — shown on the compare tool, excluded here15
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 — excluded61
Hospitals that filed this code1,299

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.

Related procedures

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

Hospitals file this code under descriptions such as 1st Hospital IP/Obs Care High Mdm 75 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, high complexity (CPT 99223) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-99223-first-hospital-or-observation-visit-high-complexity