CPT code 99221: Initial hospital care, straightforward or low MDM, 40 minutes2026 Medicare rate & RVUs in Minnesota

In Minnesota, Medicare pays $70.41 for 99221 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 99221 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 99221 covers

This is the lowest of the three initial hospital care levels. It covers an initial evaluation during a hospital inpatient or observation stay by a physician or other qualified health professional. Hospitalists, attending physicians, and consulting specialists may use this family for their initial service, depending on services already provided by practitioners of the same specialty and group. The evaluation may include a medically appropriate history and examination and a plan for a stable, uncomplicated problem.

Select 99221 using straightforward or low medical decision making, or at least 40 minutes of qualifying practitioner time on the encounter date. Document the decision making or total time used for selection. Qualifying time can include chart review, orders, care coordination, and documentation, whether or not performed on the unit. When the same practitioner provides an office or emergency department service before admitting the patient that day, report the initial hospital service rather than a separate earlier visit. For Medicare, the admitting practitioner of record appends modifier AI to identify the admission service.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Minnesota compares for 99221

Across 109 of 109 payment localities, the facility rate for 99221 runs from $69.48 in Arkansas to $99.75 in Alaska. Minnesota pays $70.41. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99221 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 99221 in every payment locality

How the 99221 rate is calculated

Each of 99221’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 99221

99221 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Codes related to 99221

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 99221 has changed in Minnesota

Price 99221 for an earlier date of service

Where the Minnesota rate applies

Minnesota is a Medicare payment area, not a city. Our Census mapping connects it to 916 cities and communities in Minnesota. Some span more than one payment area; confirm with the service ZIP.

• Ada
• Adams
• Adrian
• Afton
• Aitkin
• Akeley
• Albany
• Albert Lea

Browse all communities in Minnesota

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates