Hospital · CMS status A
99233
Subseq hosp inpt/obs high 50 min
Subsequent hospital inpatient or observation care, per day, high-level medical decision making or 50 minutes of total time. CMS 2026 wRVU 2.00. Reserved for genuinely high-acuity inpatient days.
Work RVU
2.00
2026 Medicare pays
$98.53
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 2.00 + Practice 0.80 + Malpractice 0.15 = 2.95 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.
Read the guide →
Billing guidance for 99233 is locked
- When to use it: the exact clinical situations that support billing 99233
- Documentation checklist: the 4 elements your note needs before submitting
- Common pitfalls: the 4 mistakes that get 99233 downcoded or denied
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Common modifiers
25
Common ICD-10 pairings
A41.9I50.21K72.10I26.99G93.40
Payer notes
Medicare audits 99233 aggressively. The CMS Comparative Billing Report for hospital medicine typically flags clinicians billing more than 35-40 percent of subsequent visits at the 99233 level. Use G0316 for prolonged services beyond 65 minutes (Medicare); commercial payers use 99356/99357 (deprecated by CPT but accepted by some plans) or follow CPT prolonged-service guidance.
Pairs well with
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.