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CPT 99218

99218,25 INITIAL OBSERVATION CARE

Reported by 14 hospitals in the network under the percent of billed charges methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated percentage of total billed charges.

National pricing summary

Low

$106

Average

$175

Median

$126

High

$276

Hospitals reporting this code

#HospitalLocationApproximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price.
1IOM Health System LPFort Wayne, IN$97$108$40—$48$210
2Bluffton Health System LLCBluffton, IN$128$125$43—$47$189
3Dukes Health System LLCPeru, IN$118$121$37—$36$336
4Warsaw Health System LLCWarsaw, IN$123$120$41—$41$210
5Lutheran Musculoskeletal Center LLCFort Wayne, IN$100$106$38—$46$210
6St. Joseph Health System, LLCWayne, IN$116$126$47—$47$210
7Dupont Hospital LLCWayne, IN$105$113$42—$47$189
8La Porte Hospital Company LLCLa Porte, IN$206$197$45—$69$239
9UPMC ColeCoudersport, PA$128$111$44—$53$157
10Vanderbilt Wilson County HospitalLebanon, TN$257$276$55—$63$414
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