# CPT 99231

> Medicare paid $40.00 for CPT 99231 in the office (non-facility) setting and $40.00 in a facility under the Q4 2019 Physician Fee Schedule, effective October 2019. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2019, when it increased 0.1%.

## What it is

A follow-up physician visit during an ongoing hospital or observation stay, at the lowest level — for a patient who is stable, recovering, or improving as expected, such as a post-operative patient tolerating diet advancement with no new issues. Total time on the date of the visit typically runs about 25 minutes, and documentation needs only a brief review of one or two problems.

## Selected release

- Release: Q4 2019 (2019 D)
- Effective: October 1 – December 31, 2019
- Status indicator: A
- Office (non-facility) national allowed amount: $40.00
- Facility national allowed amount: $40.00
- Sequestration: not applied

## RVUs and formula

- Work RVU: 0.76
- Office (non-facility) practice expense RVU: 0.29
- Facility practice expense RVU: 0.29
- Malpractice RVU: 0.06
- Conversion factor: 36.0391
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q4 2019)
- CMS file: https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu19d.zip
- Parsed file: PPRRVU19_OCT.csv, row 16,890
- Canonical page: https://localishealth.com/cpt/99231/2019/A
- Release-specific citation URL: https://localishealth.com/cpt/99231/2019/D
- Last significant update: 2026-08-04T03:09:13+00:00