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99221 first hosp inpatient/obs sf/low 40

Evaluation & Management

Also known as: initial hospital admission, hospital inpatient, first day hospital, initial hospital admit level 1, hospital admission straightforward, initial hospital admission level 1

Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient with straightforward or low medical decision-making complexity.

In Plain Language

Hospital admission visit; First day in the hospital

Clinical Context

Used for the initial evaluation and management of a patient admitted to an inpatient hospital setting or observation status with straightforward or low medical complexity.

RVU Breakdown

Work RVU1.63
Total RVU1.63

Est. Medicare Payment

$54.44

National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).

Billing & Documentation

E&M codes require documentation of medical decision-making (MDM) complexity or total time spent on the encounter. For 2026, time-based coding includes all physician time on the date of the encounter.

How This Code Compares

With a work RVU of 1.63, this code ranks in the 54th percentile among Evaluation & Management codes — 1.1x the median (1.54). The highest wRVU in this category is 18.46.

Specialties

Internal MedicineHospital MedicineAll Specialties

Frequently Asked Questions

What is CPT code 99221?

CPT 99221 (first hosp inpatient/obs sf/low 40) is a Evaluation & Management code. Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient with straightforward or low medical decision-making complexity.

Who uses CPT code 99221?

CPT 99221 is used by Internal Medicine, Hospital Medicine, All Specialties. Used for the initial evaluation and management of a patient admitted to an inpatient hospital setting or observation status with straightforward or low medical complexity.

When is CPT 99221 used?

Used for the initial evaluation and management of a patient admitted to an inpatient hospital setting or observation status with straightforward or low medical complexity.

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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.