Hospital · CMS status A

99232

Subseq hosp inpt/obs mod 35 min

Subsequent hospital inpatient or observation care, per day, moderate-level medical decision making or 35 minutes of total time. CMS 2026 wRVU 1.39. The workhorse code in adult hospital medicine: the most-billed subsequent-care code by hospitalists, comparable in importance to 99214 in primary care.

Work RVU
1.39
2026 Medicare pays
$68.14
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 1.39 + Practice 0.55 + Malpractice 0.10 = 2.04 total
Work (your effort)Practice expenseMalpractice
Featured guide · 6 min read
99232 vs 99233: Time vs MDM for Hospitalist Subsequent Visits

Hospitalist subsequent visits split between 99232 (moderate) and 99233 (high). Here are the time thresholds, MDM elements, and the decision tree.

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Common modifiers
25
Common ICD-10 pairings
J44.1I50.32E11.65N17.9L03.115

Payer notes

Medicare and Medicare Advantage plans pay 99232 at the standard PFS allowable. Commercial payers usually mirror this. The 99232-to-99233 ratio is one of the most-audited deltas in hospital medicine; expect post-payment review at clinician panel-level 99233 rates above 40 percent.

Pairs well with

Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.