CPT 99222 Evaluation & Management
1st hosp ip/obs moderate 55 Cost
Body System: General
Medicare Facility Rate
$117
CMS PFS CY2026
Medicare Non-Facility Rate
$117
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
2.60
Work RVU
0.67
Facility PE RVU
0.23
Malpractice RVU
3.50
Total RVU
Frequently Asked Questions
How much does 1st hosp ip/obs moderate 55 cost?
The Medicare facility rate is $117. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does 1st hosp ip/obs moderate 55 cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $117.