# CPT 99291

> Medicare paid $282.98 for CPT 99291 in the office (non-facility) setting and $220.87 in a facility under the Q3 2021 Physician Fee Schedule, effective July 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 decreased 0.6%.

## What it is

Direct, intensive physician care of a patient whose illness or injury is acutely impairing one or more vital organ systems, with a real chance of rapid deterioration — septic shock, respiratory failure, major trauma, a severe overdose. It demands high-complexity decision making and the physician's full attention devoted to that one patient, to the exclusion of everyone else. This code covers the first block of critical care time in a day, running from half an hour up to about an hour and a quarter; a shorter encounter is reported as an ordinary visit instead, and longer ones bring in a companion add-on code. The time counted includes work at the bedside and time spent elsewhere on the unit devoted solely to that patient, such as reviewing test results or talking with family about treatment decisions.

## Selected release

- Release: Q3 2021 (2021 C)
- Effective: July 1 – September 30, 2021
- Status indicator: A
- Office (non-facility) national allowed amount: $282.98
- Facility national allowed amount: $220.87
- Sequestration: not applied

## RVUs and formula

- Work RVU: 4.50
- Office (non-facility) practice expense RVU: 3.20
- Facility practice expense RVU: 1.42
- Malpractice RVU: 0.41
- 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 (Q3 2021)
- CMS file: https://www.cms.gov/files/zip/rvu21c-updated-6302021.zip
- Parsed file: PPRRVU21_JUL.csv, row 17,264
- Canonical page: https://localishealth.com/cpt/99291/2021/A
- Release-specific citation URL: https://localishealth.com/cpt/99291/2021/C
- Last significant update: 2026-08-04T03:10:45+00:00