No office rate
Both cover same-day hospital admission and discharge; 99235 is selected for moderate medical decision making or the applicable higher time threshold.
On this page
CMS RVU26D · Effective 2026-10-01
99234 Hospital care Medicare reimbursement rates in Ohio
Reports hospital inpatient or observation evaluation and management when the patient is admitted and discharged on the same date at a straightforward or low level. Compare 99234 office and facility rates across CMS payment localities in Ohio.
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 99234 in Ohio?
Ohio 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
$86.89
1 of 1 localities have a supported rate.
Payment area: Ohio
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.
Evaluation and management
About 99234: Same-day hospital admission and discharge
Reports hospital inpatient or observation evaluation and management when the patient is admitted and discharged on the same date at a straightforward or low level.
A physician or other qualified health care professional reports 99234 for hospital inpatient or observation care when the patient is admitted and discharged on the same calendar date. The encounter combines the admission evaluation and discharge-day management into one service. A typical setting is a hospital observation unit evaluating a stable symptom or condition with a same-day disposition; the code level depends on the documented service, not the diagnosis alone.
Select the code based on straightforward or low medical decision making, or on at least 45 minutes of qualifying total time on the date of the encounter. Documentation should support the admission, the same-day discharge, and the medical decision making or time used to select the level. Report one combined service rather than separating the same-day care into an initial hospital-care code and a discharge-management code.
Where the value comes from
- Work RVU2.00 · 76%
- Practice expense (office) RVU0.46 · 17%
- Malpractice RVU0.18 · 7%
21K
Medicare services in 2024 · #1126 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.
99234 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
Both cover same-day hospital admission and discharge; 99236 is for high medical decision making or the applicable higher time threshold.
No office rate
99221 reports initial hospital inpatient or observation care when the patient is not admitted and discharged on the same date.
No office rate
99238 reports discharge management when discharge occurs on a date other than the admission date, rather than the combined same-day service.
Compare 99234 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
Ohio →
Office / nonfacility
Unavailable
Facility
$86.89
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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 99234 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
13,024
- Code
- 99234
- Physician work
- 2.00
- Practice expense
- 0.46
- Malpractice
- 0.18
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.00 | × 1.000 | 2.0000 |
| Practice expense | 0.46 | × 0.913 | 0.4200 |
| Malpractice | 0.18 | × 1.008 | 0.1814 |
| Total RVUs | 2.6014 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$86.89
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2 | 1 |
| Practice expense | 0.46 | 0.913 |
| Malpractice | 0.18 | 1.008 |
(2 × 1 + 0.46 × 0.913 + 0.18 × 1.008) × $33.4009 = $86.89
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.
99234 billing questions
When is 99234 appropriate?
Use it when the patient receives hospital inpatient or observation care and is both admitted and discharged on the same calendar date, at a straightforward or low level.
Can time determine the code level?
Yes. The physician or qualified health care professional may select the level by total time on the encounter date; at least 45 minutes supports 99234.
Should admission and discharge be reported separately?
No. 99234 represents the combined same-day admission and discharge service; do not split that service into separate initial-care and discharge-management codes.
What if the patient stays overnight?
99234 is for admission and discharge on the same date. For a stay spanning dates, report the applicable hospital-care services for the separate dates instead.
What documentation supports 99234?
Document the hospital inpatient or observation encounter, admission and discharge dates, and the medical decision making or qualifying total time supporting the selected level.
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.
13,02199231,,Sbsq hosp ip/obs sf/low 25,A,,1.00,0.24,NA,0.24,,0.08,1.32,1.32,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02299232,,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
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703