Price Checker / CPT 99222
CPT 99222 — 1st hosp ip/obs moderate 55
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$117
What Medicare pays in a hospital/ASC setting
$117
What Medicare pays in a physician's office
$1,023
Based on 28 hospital(s) in our database
What do these numbers mean?
The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.
Hospital Charges for CPT 99222
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| "St. Francis Hospital & Heart Center®" , NY | — | — | 13513% |
| Columbus Springs Dublin , OH | $2,921 | — | 2399% |
| Gateways Hospital and Mental Health Center , CA | $1,433 | $1,433 | 1126% |
| Gateways Hospital and Mental Health Center Los Angeles, CA | $1,433 | — | 1126% |
| Rainier Springs , WA | $225 | — | 1068% |
| Copper Springs , AZ | $225 | — | 915% |
| Helen Hayes Hospital , NY | $984 | $984 | 742% |
| EHHS Milton Clinic , WI | $376 | $274 | 222% |
| hebrew rehabilitation center hospital , MA | $319 | $319 | 173% |
| Pine Rest Christian Mental Health Services , MI | $312 | $250 | 167% |
| RCG Taft Street , IN | $308 | — | 163% |
| Lindner Center of Hope , OH | $275 | $162 | 135% |
| Ridgeview Psychiatric Hospital and Center, Inc. Oak Ridge, TN | $500 | — | 116% |
| Highland Springs LLC , OH | $225 | $950 | 92% |
| JD McCarty Center Norman, OK | $175 | — | 62% |
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About CPT 99222
CPT code 99222 refers to “1st hosp ip/obs moderate 55”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $117 in a facility (hospital or ambulatory surgery center) and $117in a non-facility (physician's office) setting.
These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.
What to do if you were overcharged
- Upload your bill— we'll identify this code and compare it against the rates shown above.
- Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
- Negotiate or let us handle it — 25% of savings, no savings = no fee.