PFS ExplorerMedicare Physician Fee Schedule · 2026

Search codes

Search for a command to run...

Model Your Practice

99238

Hosp ip/obs dschrg mgmt 30/<

Add to my model
Code typePrimary
Payment statusActive (A)
Global periodNone

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary99238Hosp ip/obs dschrg mgmt 30/<
1
$74.82
$74.82
Add-on90833Psytx w pt w e/m 30 min
0
$81.50/ unit
$65.80/ unit
Add-on90836Psytx w pt w e/m 45 min
0
$103.21/ unit
$83.17/ unit
Add-on90838Psytx w pt w e/m 60 min
0
$136.61/ unit
$110.22/ unit
Add-on96160Pt-focused hlth risk assmt
0
$3.01/ unit
$3.01/ unit
Add-on96161Caregiver health risk assmt
0
$3.34/ unit
$3.34/ unit
Add-onG0506Comp asses care plan ccm svc
0
$66.47/ unit
$38.41/ unit
Add-onG0545Inherent visit to inpt
0
$48.43/ unit
$40.42/ unit
Whole procedure · 1.50 wRVU credited
$74.82
$74.82

RVU Breakdown

Component
Office
Facility
Work
1.50
1.50
Practice expense
0.62
0.62
Malpractice
0.12
0.12
Total RVU
2.24
2.24

Payment Policy & Modifiers

Allowed adjustments
Assistant surgeon -80/81/8216% · documented
Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.
Not applicable to this code
Bilateral -50Multiple procedure Co-surgeon -62Team surgeon -66Prof / tech split