Hospital · CMS status A
99236
Hosp same-day adm/disch high 85 min
Hospital inpatient or observation care services for evaluation and management of a patient admitted and discharged on the same date, high-level medical decision making or 85 minutes total time. CMS 2026 wRVU 4.20.
Work RVU
4.20
2026 Medicare pays
$207.42
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 4.20 + Practice 1.69 + Malpractice 0.32 = 6.21 total
Work (your effort)Practice expenseMalpractice
Billing guidance for 99236 is locked
- When to use it: the exact clinical situations that support billing 99236
- Documentation checklist: the 3 elements your note needs before submitting
- Common pitfalls: the 2 mistakes that get 99236 downcoded or denied
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Common modifiers
25
Common ICD-10 pairings
I50.21I20.0J44.1
Payer notes
Medicare audits 99236 closely given the high allowable; expect post-payment review at panel-level 99236 rates above the specialty average.
Pairs well with
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.