Price Checker / CPT 99234
CPT 99234 — Hosp ip/obs sm dt sf/low 45
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$88
What Medicare pays in a hospital/ASC setting
$88
What Medicare pays in a physician's office
$485
Based on 15 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 99234
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 , CA | $1,256 | $1,256 | 1325% |
| Gateways Hospital and Mental Health Center Los Angeles, CA | $1,256 | — | 1325% |
| HealthSource Saginaw , MI | — | — | 1211% |
| HealthSource Saginaw , MI | — | — | 1211% |
| EHHS Milton Clinic , WI | $365 | $266 | 314% |
| BARAGA COUNTY MEMORIAL HOSPITAL , MI | $331 | $331 | 275% |
| Pine Rest Christian Mental Health Services , MI | $323 | $258 | 266% |
| RCG Taft Street , IN | $298 | $298 | 238% |
| Highland Springs LLC , OH | $225 | $950 | 155% |
| Porter-Starke Services Inpatient Care Center Valparaiso, IN | $200 | — | 97% |
| BayPointe Hospital Mobile, AL | $160 | — | 81% |
| EastPointe Hospital Daphne, AL | $160 | — | 81% |
| Pathways Behavioral Health Services , TN | $150 | $150 | 70% |
| Ascension Saint Thomas Highlands , TN | — | — | 39% |
| Ascension Saint Thomas River Park , TN | — | — | 39% |
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About CPT 99234
CPT code 99234 refers to “Hosp ip/obs sm dt sf/low 45”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $88 in a facility (hospital or ambulatory surgery center) and $88in 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.