{
    "code": "99215",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99215/2014/B",
    "release_specific_url": "https://localishealth.com/cpt/99215/2014/D",
    "description": "The most complex established-patient office visit — for example, a severe flare of a chronic illness, or a new problem that threatens life or bodily function and requires a high-risk management decision such as a major medication change or weighing hospitalization. Total visit time typically runs about 40 to 54 minutes, and documentation must support high complexity in the problems addressed, the data reviewed, and the risk of the management plan. It is the highest-level established-patient office visit.",
    "answer": {
        "question": "How much did Medicare pay for CPT 99215 in Q4 2014?",
        "text": "Medicare paid $144.37 for CPT 99215 in the office (non-facility) setting and $111.41 in a facility under the Q4 2014 Physician Fee Schedule, effective October 2014. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment."
    },
    "release": {
        "schedule": "pfs",
        "year": 2014,
        "quarter": "D",
        "label": "Q4 2014",
        "effective": "October 1 – December 31, 2014",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 144.37,
        "facility": 111.41,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 2.11,
        "practice_expense_non_facility": 1.79,
        "practice_expense_facility": 0.87,
        "malpractice": 0.13
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.8228,
    "source": {
        "label": "Physician relative value file (Q4 2014)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu14d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2014/D",
        "file": "PPRRVU14_V0815_v5.csv",
        "row": 15750,
        "sha256": "9ff6da39ad421c38c816089ae3bed4bd754a642336efa8e8901e9cc38cca8705"
    },
    "modified_at": "2026-08-04T03:05:30+00:00"
}