A system and method for accounting and billing patients in a hospital environment. A hospitalized patient is associated with a patient identifier. Billable services provided to the hospitalized patient are associated with the patient identifier. If the billable service is provided by a physician, a physician identifier is also associated with the billable service. The hospitalized patient is scored and a current procedural terminology (CPT) assignment manager assigns CPT codes to the billable service. A bill generator receives the patient data, patient insurance information, physician insurance information, and CPT codes and generates a bill for the billable services provided to the hospitalized patient.