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Procedure price report

Follow-up observation visit, high complexity

CPT 99226the billing code this page is about

A clinician's follow-up visit on a later day of a hospital observation stay for a complex or worsening problem; billed once for each such day. This code was retired after 2022.

Hospitals typically charge $174 cash for this outpatient procedure — the median across 265 hospitals that filed a usable cash price; the average of the middle 60% is $167. Most fall between $91 and $250 (20th–80th percentile).

Hospitals
265
States
43
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 265 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
$77$109$174$220$345

The most expensive tenth of hospitals charges at least 4.5× what the cheapest tenth charges ($77 vs $345).

How the prices are spread

$65 – $78: 19 hospitals$65$78 – $94: 24 hospitals$94 – $113: 25 hospitals$94$113 – $135: 15 hospitals$135 – $162: 25 hospitals$135$162 – $194: 38 hospitals$194 – $232: 43 hospitals$194$232 – $278: 19 hospitals$278 – $334: 15 hospitals$278$334 – $400: 17 hospitals$334median $174price bands are equal on a log scale
Hospitals per price band (240 of 265 — the bands cover the 5th to 95th percentile)
FromToHospitals
$65$7819
$78$9424
$94$11325
$113$13515
$135$16225
$162$19438
$194$23243
$232$27819
$278$33415
$334$40017

By state

The median cash price in each state, against the national median of $174.

Alaska: 2 hospitals filed a usable price — fewer than 10, so no figureAKMaine: 4 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: 1 hospital filed a usable price — fewer than 10, so no figureIDMontana: 2 hospitals filed a usable price — fewer than 10, so no figureMTNorth Dakota: 2 hospitals filed a usable price — fewer than 10, so no figureNDMinnesota: 3 hospitals filed a usable price — fewer than 10, so no figureMNIllinois: median $161 across 16 hospitalsIL$161Wisconsin: median $195 across 20 hospitalsWI$195Michigan: median $177 across 17 hospitalsMI$177New York: median $126 across 10 hospitalsNY$126Massachusetts: no hospital in the corpus filed a usable priceMAOregon: median $193 across 15 hospitalsOR$193Nevada: 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 $145 across 18 hospitalsIA$145Indiana: median $79 across 15 hospitalsIN$79Ohio: 9 hospitals filed a usable price — fewer than 10, so no figureOHPennsylvania: 3 hospitals filed a usable price — fewer than 10, so no figurePANew Jersey: no hospital in the corpus filed a usable priceNJConnecticut: no hospital in the corpus filed a usable priceCTRhode Island: no hospital in the corpus filed a usable priceRICalifornia: median $400 across 11 hospitalsCA$400Utah: 1 hospital filed a usable price — fewer than 10, so no figureUTColorado: 6 hospitals filed a usable price — fewer than 10, so no figureCONebraska: 7 hospitals filed a usable price — fewer than 10, so no figureNEMissouri: 5 hospitals filed a usable price — fewer than 10, so no figureMOKentucky: 6 hospitals filed a usable price — fewer than 10, so no figureKYWest Virginia: 8 hospitals filed a usable price — fewer than 10, so no figureWVVirginia: 3 hospitals filed a usable price — fewer than 10, so no figureVAMaryland: no hospital in the corpus filed a usable priceMDDelaware: no hospital in the corpus filed a usable priceDEArizona: 4 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: 8 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 $109 across 11 hospitalsOK$109Louisiana: 2 hospitals filed a usable price — fewer than 10, so no figureLAMississippi: 5 hospitals filed a usable price — fewer than 10, so no figureMSAlabama: 2 hospitals filed a usable price — fewer than 10, so no figureALGeorgia: median $73 across 10 hospitalsGA$73Hawaii: 1 hospital filed a usable price — fewer than 10, so no figureHITexas: 4 hospitals filed a usable price — fewer than 10, so no figureTXFlorida: 1 hospital filed a usable price — fewer than 10, so no figureFL
Cash price by state, most expensive first. National median $174. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
California CA11$400+130%$376 – $400
Wisconsin WI20$195+12%$195 – $213
Oregon OR15$193+11%$174 – $316
Michigan MI17$177+2%$76 – $195
Illinois IL16$161−8%$79 – $315
Iowa IA18$145−17%$116 – $208
New York NY10$126−28%$61 – $239
Oklahoma OK11$109−37%$109 – $109
Indiana IN15$79−55%$49 – $143
Georgia GA10$73−58%$73 – $172
Ohio OH9not enough hospitals filed a usable price
Kansas KS8not enough hospitals filed a usable price
Tennessee TN8not enough hospitals filed a usable price
West Virginia WV8not enough hospitals filed a usable price
Nebraska NE7not enough hospitals filed a usable price
Colorado CO6not enough hospitals filed a usable price
Kentucky KY6not enough hospitals filed a usable price
Arkansas AR5not enough hospitals filed a usable price
Missouri MO5not enough hospitals filed a usable price
Mississippi MS5not enough hospitals filed a usable price
Washington WA5not enough hospitals filed a usable price
Arizona AZ4not enough hospitals filed a usable price
Maine ME4not enough hospitals filed a usable price
Texas TX4not enough hospitals filed a usable price
Wyoming WY4not enough hospitals filed a usable price
Minnesota MN3not enough hospitals filed a usable price
North Carolina NC3not enough hospitals filed a usable price
Pennsylvania PA3not enough hospitals filed a usable price
Virginia VA3not enough hospitals filed a usable price
Alaska AK2not enough hospitals filed a usable price
Alabama AL2not enough hospitals filed a usable price
Louisiana LA2not enough hospitals filed a usable price
Montana MT2not enough hospitals filed a usable price
North Dakota ND2not enough hospitals filed a usable price
Nevada NV2not enough hospitals filed a usable price
South Carolina SC2not enough hospitals filed a usable price
Vermont VT2not enough hospitals filed a usable price
Florida FL1not enough hospitals filed a usable price
Hawaii HI1not enough hospitals filed a usable price
Idaho ID1not enough hospitals filed a usable price
New Mexico NM1not enough hospitals filed a usable price
South Dakota SD1not enough hospitals filed a usable price
Utah UT1not 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 $174.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care125$165$79 – $255
Children’s4fewer than 20 hospitals
Critical access135$182$100 – $242
Ownership
For-profit26$91$76 – $323
Government79$185$107 – $251
Non-profit159$174$103 – $248
System affiliation
Part of a system179$174$79 – $220
Independent86$176$113 – $297

Cash price vs list price

Median list price (chargemaster)$244
Median cash price$174
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

167 hospitals filed a usable inpatient cash price for this code. The median is $174 and the average of the middle 60% is $159; most fall between $84 and $233.

Cash price percentiles, inpatient, across 167 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$100$174$207$345

The most expensive tenth of hospitals charges at least 4.5× what the cheapest tenth charges ($76 vs $345).

Of the 179 hospitals that filed this code inpatient, 167 gave a usable cash price; 0 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 12 a list price only.

How complete is this

265 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 287 hospitals that filed this code at all gave us
Usable cash price — counted265
Cash price carrying a plausibility flag — shown on the compare tool, excluded here4
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 — excluded18
Hospitals that filed this code287

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, “Follow-up observation visit, high complexity (CPT 99226) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-99226-follow-up-observation-visit-high-complexity