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Physician Service

99213 Medicare Reimbursement Rate (2026)

Current CMS pricing and breakdown for Office o/p est low 20 min.

CPT Code 99213

National Average Payment

Non-Facility (Private Office) Rate

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$95.19
Effective Jan 1, 2026

⚠️ This is a National Estimate

Your actual reimbursement depends on your specific Zip Code and GPCI adjustments (e.g., New York vs. Texas).

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Code Description

Office o/p est low 20 min

2026 Breakdown

ComponentOffice (Non-Fac)Facility (Hosp)
Work RVU1.31.3
Practice Expense (PE)1.460.33
Malpractice (MP)0.090.09
Total RVUs2.851.72

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Nearby Codes

9921299214