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
Billing guidance for 99235 is locked
- When to use it: the exact clinical situations that support billing 99235
- Documentation checklist: the 3 elements your note needs before submitting
- Common pitfalls: the 2 mistakes that get 99235 downcoded or denied
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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.