Hospital inpatient & observation
99223 - RVUs & Medicare payment (2026)
Initial hospital or observation visit, level 3.
| Component | Non-facility | Facility |
|---|---|---|
| Work RVU | 3.50 | 3.50 |
| Practice expense RVU | 0.90 | 0.90 |
| Malpractice RVU | 0.28 | 0.28 |
| Total RVUs | 4.68 | 4.68 |
| National payment (CF $33.4009) | $156.32 | $156.32 |
| Qualifying APM payment (CF $33.5675) | $157.10 | $157.10 |
How 99223 payment varies by locality
Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 99223 ranges from $147.54 in Arkansas (AR) to $212.52 in Alaska (AK); calculate 99223 for your locality.
Global period: XXX
No global period: the global surgery concept does not apply to this code.
Related codes - hospital inpatient & observation
- 99221 · initial hospital or observation visit, level 1
- 99222 · initial hospital or observation visit, level 2
- 99231 · subsequent hospital or observation visit, level 1
- 99232 · subsequent hospital or observation visit, level 2
- 99233 · subsequent hospital or observation visit, level 3
- 99238 · hospital discharge management, 30 minutes or less
- 99239 · hospital discharge management, more than 30 minutes
Frequently asked questions
How much does Medicare pay for 99223 in 2026?
What is the work RVU for 99223?
Why are the facility and non-facility amounts different?
Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.