CPT 99231 Evaluation & Management

Sbsq hosp ip/obs sf/low 25 Cost

Body System: General

Medicare Facility Rate

$44

CMS PFS CY2026

Medicare Non-Facility Rate

$44

Office/clinic setting

Relative Value Units (RVUs)

Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)

1.00

Work RVU

0.24

Facility PE RVU

0.08

Malpractice RVU

1.32

Total RVU

Frequently Asked Questions

How much does Sbsq hosp ip/obs sf/low 25 cost?

The Medicare facility rate is $44. Commercial insurance typically pays 150-250% of Medicare rates (varies).

How much does Sbsq hosp ip/obs sf/low 25 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 $44.