# CPT 99213

> Medicare paid $92.47 for CPT 99213 in the office (non-facility) setting and $68.04 in a facility under the Q2 2021 Physician Fee Schedule, effective April 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2021, when it increased 21.4%.

## What it is

A routine established-patient visit for a problem of low-to-moderate complexity — for example, checking in on one or two stable chronic conditions like well-controlled hypertension or diabetes, or evaluating a new minor issue such as a cough or ankle sprain. Total visit time typically runs about 20 to 29 minutes, and documentation should show the problem(s) addressed, any data reviewed (such as a lab result), and a low risk of complications from the plan of care. It is one of the most frequently billed services in all of medicine.

## Selected release

- Release: Q2 2021 (2021 B)
- Effective: April 1 – June 30, 2021
- Status indicator: A
- Office (non-facility) national allowed amount: $92.47
- Facility national allowed amount: $68.04
- Sequestration: not applied

## RVUs and formula

- Work RVU: 1.30
- Office (non-facility) practice expense RVU: 1.25
- Facility practice expense RVU: 0.55
- Malpractice RVU: 0.10
- 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 (Q2 2021)
- CMS file: https://www.cms.gov/files/zip/rvu21b-updated-03022021.zip
- Parsed file: PPRRVU21_APR.csv, row 17,162
- Canonical page: https://localishealth.com/cpt/99213/2021/A
- Release-specific citation URL: https://localishealth.com/cpt/99213/2021/B
- Last significant update: 2026-08-04T03:10:33+00:00