No office rate
Both cover same-date admission and discharge. Choose 99234 for straightforward or low-level care; 99235 is for moderate-level care.
On this page
CMS RVU26D · Effective 2026-10-01
99235 Hospital care Medicare reimbursement rates in Nevada
Reports hospital inpatient or observation admission and discharge on the same date when the combined encounter supports moderate medical decision making or qualifying total time. Compare 99235 office and facility rates across CMS payment localities in Nevada.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 99235 in Nevada?
Nevada has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$141.59
1 of 1 localities have a supported rate.
Payment area: Nevada**
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Hospital inpatient/observation
About 99235: Same-day hospital admission and discharge, moderate complexity
Reports hospital inpatient or observation admission and discharge on the same date when the combined encounter supports moderate medical decision making or qualifying total time.
99235 represents hospital inpatient or observation care when the same physician or qualified health care professional admits and discharges the patient on the same calendar date, with moderate medical decision making. Hospitalists and other attending clinicians may report it after assessing an acute problem, starting treatment or monitoring, and determining that the patient can leave that day. The service combines the admission and discharge work rather than representing an admission alone.
Select the code based on moderate medical decision making or total time. When time is the basis, the physician’s or qualified health care professional’s total time on the date must meet or exceed 70 minutes. Document the same-day admission and discharge, the assessment and plan supporting the selected level, and total time when used. CMS fee-schedule valuation treats this as one combined E/M service; admission and discharge work for that date are not split into separate services.
Where the value comes from
- Work RVU3.24 · 76%
- Practice expense (office) RVU0.79 · 18%
- Malpractice RVU0.25 · 6%
56.5K
Medicare services in 2024 · #738 by national volume
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.
99235 compared with similar codes
Office rates for Nevada, from the same CMS release.
No office rate
Both cover same-date admission and discharge. 99236 requires high-level care, whereas 99235 represents moderate-level care.
No office rate
99222 is initial hospital inpatient or observation care, not the combined same-day admission and discharge service represented by 99235.
No office rate
99238 reports discharge management on its own; 99235 combines admission and discharge when both occur on the same date.
Compare 99235 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Nevada** →
Office / nonfacility
Unavailable
Facility
$141.59
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 99235 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
13,025
- Code
- 99235
- Physician work
- 3.24
- Practice expense
- 0.79
- Malpractice
- 0.25
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.24 | × 1.000 | 3.2400 |
| Practice expense | 0.79 | × 1.001 | 0.7908 |
| Malpractice | 0.25 | × 0.833 | 0.2082 |
| Total RVUs | 4.2390 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nevada**$141.59
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.24 | 1 |
| Practice expense | 0.79 | 1.001 |
| Malpractice | 0.25 | 0.833 |
(3.24 × 1 + 0.79 × 1.001 + 0.25 × 0.833) × $33.4009 = $141.59
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
99235 billing questions
When should 99235 be selected instead of 99234 or 99236?
Use 99235 when the same-day admission and discharge encounter supports moderate medical decision making or the applicable total-time threshold. 99234 represents straightforward or low-level care, while 99236 represents high-level care.
Can admission and discharge management be billed separately on the same date?
99235 covers the combined same-day admission and discharge service. Do not divide that encounter into a separate initial hospital care service and discharge management service.
What time supports 99235?
When selecting the code by time, total physician or qualified health care professional time on the date must meet or exceed 70 minutes. There is no upper time limit.
Can 99235 be used for an observation stay?
Yes. It covers same-date admission and discharge for hospital inpatient or observation care when the encounter meets the moderate level or time criterion.
What documentation supports reporting 99235?
Document the admission and discharge on the same calendar date and the work supporting moderate medical decision making. If selecting by time, record the total time for the date.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
13,02299232,,Sbsq hosp ip/obs moderate 35,A,,1.59,0.40,NA,0.40,,0.12,2.11,2.11,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02399233,,Sbsq hosp ip/obs high 50,A,,2.40,0.62,NA,0.62,,0.18,3.20,3.20,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02499234,,Hosp ip/obs sm dt sf/low 45,A,,2.00,0.46,NA,0.46,,0.18,2.64,2.64,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02599235,,Hosp ip/obs same date mod 70,A,,3.24,0.79,NA,0.79,,0.25,4.28,4.28,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02699236,,Hosp ip/obs same date hi 85,A,,4.30,1.02,NA,1.02,,0.36,5.68,5.68,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02799238,,Hosp ip/obs dschrg mgmt 30/<,A,,1.50,0.62,NA,0.62,,0.12,2.24,2.24,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02899239,,Hosp ip/obs dschrg mgmt >30,A,,2.15,0.88,NA,0.88,,0.16,3.19,3.19,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097