# CPT 99222

> Medicare paid $138.89 for CPT 99222 in the office (non-facility) setting and $138.89 in a facility under the Q3 2017 Physician Fee Schedule, effective July 2017. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2017, when it increased 0.5%.

## What it is

The first physician visit of a hospital or observation admission at the middle level — for example, admitting a patient with pneumonia or a heart-failure flare that needs IV medication and monitoring. It reflects a moderate number of problems, moderate data review (labs, imaging), and moderate risk; total time typically runs about 55 minutes.

## Selected release

- Release: Q3 2017 (2017 C)
- Effective: July 1 – September 30, 2017
- Status indicator: A
- Office (non-facility) national allowed amount: $138.89
- Facility national allowed amount: $138.89
- Sequestration: not applied

## RVUs and formula

- Work RVU: 2.61
- Office (non-facility) practice expense RVU: 1.05
- Facility practice expense RVU: 1.05
- Malpractice RVU: 0.21
- Conversion factor: 35.8887
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q3 2017)
- CMS file: https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu17c.zip
- Parsed file: PPRRVU17_JULY_V0503.csv, row 16,346
- Canonical page: https://localishealth.com/cpt/99222/2017/A
- Release-specific citation URL: https://localishealth.com/cpt/99222/2017/C
- Last significant update: 2026-08-04T03:07:49+00:00