# CPT 99203

> Medicare paid $113.75 for CPT 99203 in the office (non-facility) setting and $84.44 in a facility under the Q1 2021 Physician Fee Schedule, effective January 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 4.0% increase from the previous quarter.

## What it is

A low-to-moderate complexity visit for a patient the practice has not seen recently — for example, a new patient establishing care for a stable condition or presenting with a single uncomplicated problem, such as seasonal allergies. Total visit time typically runs about 30 to 44 minutes; new-patient visits generally take longer than an established-patient visit at the same level because no prior chart exists to build on.

## Selected release

- Release: Q1 2021 (2021 A)
- Effective: January 1 – March 31, 2021
- Status indicator: A
- Office (non-facility) national allowed amount: $113.75
- Facility national allowed amount: $84.44
- Sequestration: not applied

## RVUs and formula

- Work RVU: 1.60
- Office (non-facility) practice expense RVU: 1.51
- Facility practice expense RVU: 0.67
- Malpractice RVU: 0.15
- Conversion factor: 34.8931
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q1 2021)
- CMS file: https://www.cms.gov/files/zip/rvu21a-updated-01052021.zip
- Parsed file: PPRRVU21_JAN.csv, row 17,146
- Canonical page: https://localishealth.com/cpt/99203/2021/A
- Release-specific citation URL: https://localishealth.com/cpt/99203/2021/A
- Last significant update: 2026-08-04T03:10:16+00:00