Price Checker / CPT 99221
How much does Hospital admission — initial, low complexity cost?
CPT 99221 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 15x the fair price — among the most extreme markups. Dispute this.
Fair price
$150–$180
What this should cost
With insurance
~$182,700
Typical out-of-pocket
Overcharged if over
$230
Push back above this
The average hospital charge of $2,538 is $2,368 over the fair price (about 15x the fair rate).
What hospitals charge for Hospital admission — initial, low complexity
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Oregon Health and Science University , OR | $13,781 | $8,957 | 18402% |
| Good Samaritan University Hospital , NY | — | — | 15569% |
| St. Catherine of Siena Hospital SMITHTOWN, NY | — | — | 15569% |
| Roane County Medical Center , TN | — | — | 6035% |
| Gateways Hospital and Mental Health Center Los Angeles, CA | $1,036 | — | 1291% |
| Molokai General Hospital KAUNAKAKAI, HI | $455 | — | 938% |
| EHHS Milton Clinic , WI | $278 | $203 | 273% |
| Pine Rest Christian Mental Health Services GRAND RAPIDS, MI | $268 | $214 | 260% |
| Ridgeview Psychiatric Hospital and Center, Inc. Oak Ridge, TN | $400 | — | 238% |
| Highland Springs LLC BEACHWOOD, OH | $200 | $950 | 169% |
| Barnes-Kasson County Hospital SUSQUEHANNA, PA | $185 | $130 | 148% |
| Henry Ford Brighton Center for Recovery Brighton, MI | — | — | 100% |
| BayPointe Hospital Mobile, AL | $140 | — | 88% |
| EastPointe Hospital Daphne, AL | $140 | — | 88% |
| Carolina Dunes Behavioral Health Leland, NC | $290 | — | 61% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Hospital admission — initial, low complexity
CPT code 99221 refers to hospital admission — initial, low complexity (billing description: "1st hosp ip/obs sf/low 40"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $74 in a facility (hospital or surgery center) and $74 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.