{
    "code": "99212",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99212/2018/A",
    "release_specific_url": "https://localishealth.com/cpt/99212/2018/C",
    "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 Q3 2018?",
        "text": "Medicare paid $44.64 for CPT 99212 in the office (non-facility) setting and $25.92 in a facility under the Q3 2018 Physician Fee Schedule, effective July 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 increased 1.1%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2018,
        "quarter": "C",
        "label": "Q3 2018",
        "effective": "July 1 – September 30, 2018",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 44.64,
        "facility": 25.92,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.48,
        "practice_expense_non_facility": 0.72,
        "practice_expense_facility": 0.2,
        "malpractice": 0.04
    },
    "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 (Q3 2018)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu18c1.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2018/C",
        "file": "PPRRVU18_JUL.csv",
        "row": 16504,
        "sha256": "514e3c115f8e62a35eb5f78fef7ed12ed7b60b22a5fe3f3f1bb5aadf119663c5"
    },
    "modified_at": "2026-08-04T03:08:27+00:00"
}