CPT 99226

Observation Care

Retired code3 hospitals with prices

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

This code is retired. Some hospitals still list it.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Prices for CPT 99226 by hospital
Hospital	Commercial insurance rates (lowest – highest)	Cash price	List price (before discounts)
Coulee Medical CenterGrand Coulee	—	$326	$362
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01	—	$60.45 – $174Doctor’s fee: $112 – $192	$93.00 – $268Doctor’s fee: $173 – $295
Three Rivers HospitalBrewster	—	Doctor’s fee: $245	Doctor’s fee: $245

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.

How hospitals also write this code

Some price files write it differently. These are counted as CPT 99226:

99226P (with a letter after it, P; 4 price lines)
99226T (with a letter after it, T; 2 price lines)