Hospital · CMS status A

99235

Hosp same-day adm/disch mod 70 min

Hospital inpatient or observation care services for evaluation and management of a patient admitted and discharged on the same date, moderate-level medical decision making or 70 minutes total time. CMS 2026 wRVU 3.24.

Work RVU
3.24
2026 Medicare pays
$159.99
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 3.24 + Practice 1.30 + Malpractice 0.25 = 4.79 total
Work (your effort)Practice expenseMalpractice

When to use it

The most common same-day admit-and-discharge code. Use 99235 when the encounter reflects moderate complexity: prescription drug management initiated or adjusted, two or more chronic problems addressed, or one undiagnosed problem with uncertain prognosis.

Full guidance

Real example: same-day observation admit for chest pain rule-out with troponin trend, stress test discussion, and prescription of new statin or aspirin therapy.

Documentation checklist

Common pitfalls

Common modifiers
25
Common ICD-10 pairings
R07.9J44.1I50.32

Payer notes

Medicare and commercial payers pay 99235 at the standard PFS allowable. Most same-day admit/discharge claims fall under 99235 rather than the higher 99236.

Pairs well with

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