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CPT 99225

99225,25 SUBSEQUENT OBSERVATION CARE

Reported by 3 hospitals in the network under the per diem 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 per diem rate paid per day of care.

National pricing summary

Low

$28

Average

$71

Median

$92

High

$92

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.
1Dukes Health System LLCPeru, IN$28$28$3—$23$258
2Lutheran Musculoskeletal Center LLCFort Wayne, IN$92$92$8—$30$161
3Dupont Hospital LLCWayne, IN$92$92$8—$30$145

Look up this code directly

Ask Claude or any MCP client for CPT 99225 pricing at a specific hospital — see how to connect.

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