How Much Does Subsequent Hospital Inpatient/observation Straightforward/low 25 Cost?
Also known as: Sbsq hosp ip/obs sf/low 25 (CPT 99231)
A follow-up visit from your doctor while you are in the hospital, for a straightforward or low-complexity issue.
Subsequent Hospital Inpatient/observation Straightforward/low 25 (CPT 99231) costs $44 at Medicare rates.
The rates shown below represent the complete Medicare reimbursement for this service. No separate facility fee applies for this type of procedure.
Patient Guide: Subsequent Hospital Inpatient/observation Straightforward/low 25
What you need to know before your appointment
What to Expect
Your doctor will check on your progress, review vital signs and test results, and may adjust your treatment plan. This is a brief check-in visit.
How Long Does It Take?
25 minutes
Common Reasons Doctors Order This
Daily hospital rounds, stable patients recovering from surgery, monitoring improvement
How to Prepare
Write down any new symptoms or concerns since the last visit. Note any issues with sleep, pain, or medications.
Procedures Commonly Done Together
These procedures are frequently performed alongside Sbsq hosp ip/obs sf/low 25
How to Reduce Your Cost for Sbsq hosp ip/obs sf/low 25
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (1.32) x CF ($33.40) = $44
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Sbsq hosp ip/obs sf/low 25 cost?
The Medicare facility rate for Sbsq hosp ip/obs sf/low 25 is $44. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Sbsq hosp ip/obs sf/low 25 cost without insurance?
Without insurance, the cost of Sbsq hosp ip/obs sf/low 25 can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Sbsq hosp ip/obs sf/low 25?
Most commercial health insurance plans and Medicare cover Sbsq hosp ip/obs sf/low 25 when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.