Price Checker / CPT 99223
How much does Hospital admission — initial, high complexity cost?
CPT 99223 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is a bit above the fair range. It may be worth asking for the cash/self-pay rate.
Fair price
$320–$370
What this should cost
With insurance
~$217,400
Typical out-of-pocket
Overcharged if over
$460
Push back above this
The average hospital charge of $395 is $45 over the fair price.
What hospitals charge for Hospital admission — initial, high 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 |
|---|---|---|---|
| Gateways Hospital and Mental Health Center Los Angeles, CA | $1,807 | — | 1056% |
| EHHS Milton Clinic , WI | $554 | $404 | 254% |
| Haven Behavioral Hospital of West Chester WEST CHESTER, PA | $544 | — | 248% |
| hebrew rehabilitation center hospital Boston, MA | $424 | — | 171% |
| Pine Rest Christian Mental Health Services GRAND RAPIDS, MI | $418 | $334 | 167% |
| Lindner Center of Hope MASON, OH | $405 | — | 149% |
| Mackinac Straits Health System Saint Ignace, MI | $373 | — | 125% |
| Barnes-Kasson County Hospital SUSQUEHANNA, PA | $345 | $242 | 121% |
| Pathways Behavioral Health Services , TN | $301 | $301 | 93% |
| Highland Springs LLC BEACHWOOD, OH | $300 | $950 | 92% |
| Henry Ford Kingswood Hospital Ferndale, MI | $640 | — | 78% |
| Porter-Starke Services Inpatient Care Center Valparaiso, IN | $232 | — | 69% |
| NATCHAUG HOSPITAL MANSFIELD CENTER, CT | $410 | — | 65% |
| Generations Behavioral Health Geneva GENEVA, CA | $343 | — | 63% |
| Generations Behavioral Health Youngstown Youngstown, OH | $343 | — | 63% |
Were you billed for this procedure?
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About Hospital admission — initial, high complexity
CPT code 99223 refers to hospital admission — initial, high complexity (billing description: "1st hosp ip/obs high 75"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $156 in a facility (hospital or surgery center) and $156 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.