{
    "code": "69200",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/69200/2018/A",
    "release_specific_url": "https://localishealth.com/cpt/69200/2018/D",
    "answer": {
        "question": "How much did Medicare pay for CPT 69200 in Q4 2018?",
        "text": "Medicare paid $83.88 for CPT 69200 in the office (non-facility) setting and $48.60 in a facility under the Q4 2018 Physician Fee Schedule, effective October 2018. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2018, when it decreased 0.5%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2018,
        "quarter": "D",
        "label": "Q4 2018",
        "effective": "October 1 – December 31, 2018",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 83.88,
        "facility": 48.6,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.77,
        "practice_expense_non_facility": 1.46,
        "practice_expense_facility": 0.48,
        "malpractice": 0.1
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.9996,
    "source": {
        "label": "Physician relative value file (Q4 2018)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu18d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2018/D",
        "file": "PPRRVU18_OCT.csv",
        "row": 11447,
        "sha256": "c6312c12acd1b8ed78b409e8508357929aa7e764e333ec568ebb9c0774b7dc4d"
    },
    "modified_at": "2026-08-04T03:08:37+00:00"
}
