Initial Hospital Admission — Low Complexity
What should this cost?
Medicare Pays
$130
National benchmark
Typical Range
$250–$600
What hospitals charge
Markup
3×
Above Medicare rate
What this code means on your bill
The physician first evaluation when you are admitted to the hospital for straightforward conditions.
Commonly billed for
Simple hospital admissions, observation stays
What to watch for
Upcoding
If your visit seemed straightforward but you see a high-level code, the provider may have billed for a more complex service than what was performed. Compare the code level to the time you actually spent with the doctor.
Duplicate charges
Check if this code appears more than once on the same date of service. Unless you had the same procedure performed twice (rare), a duplicate is likely a billing error.
Price check
If you're being charged more than 720 for this service, it's significantly above the typical range. Request an itemized bill and compare against the Medicare rate of $130.
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