{
    "code": "99212",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99212/2016/A",
    "release_specific_url": "https://localishealth.com/cpt/99212/2016/B",
    "description": "A short established-patient visit for a single, straightforward problem — for example, a routine medication refill check or a minor, self-limited issue like a mild rash. Total visit time typically runs about 10 to 19 minutes, and documentation needs to show one uncomplicated problem, minimal or no data reviewed, and low risk from the plan of care.",
    "answer": {
        "question": "How much did Medicare pay for CPT 99212 in Q2 2016?",
        "text": "Medicare paid $43.68 for CPT 99212 in the office (non-facility) setting and $25.42 in a facility under the Q2 2016 Physician Fee Schedule, effective April 2016. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2016, when it decreased 1.2%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2016,
        "quarter": "B",
        "label": "Q2 2016",
        "effective": "April 1 – June 30, 2016",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 43.68,
        "facility": 25.42,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.48,
        "practice_expense_non_facility": 0.7,
        "practice_expense_facility": 0.19,
        "malpractice": 0.04
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.8043,
    "source": {
        "label": "Physician relative value file (Q2 2016)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu16b.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2016/B",
        "file": "PPRRVU16_April_V0202.csv",
        "row": 16138,
        "sha256": "a6f009bac8359a1f7d870e6b668dd2e69d1658423373dbb0ca0c267cdae773b9"
    },
    "modified_at": "2026-08-04T03:06:42+00:00"
}