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Physician Service

99215 Medicare Reimbursement Rate (2026)

Current CMS pricing and breakdown for Office o/p est hi 40 min.

CPT Code 99215

National Average Payment

Non-Facility (Private Office) Rate

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$192.38
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 hi 40 min

2026 Breakdown

ComponentOffice (Non-Fac)Facility (Hosp)
Work RVU2.82.8
Practice Expense (PE)2.750.75
Malpractice (MP)0.210.21
Total RVUs5.763.76

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Nearby Codes

9921499216