Specialty rate rollup
Primary Care
Office visits, preventive care, and the routine services that make up most of a primary-care practice.
Current national rates
Q3 2025 releaseNon-facility amounts, GPCI 1.000, before sequestration. Change is versus the prior release.
| Code | Status | National amount | Change |
|---|---|---|---|
| 99213 Established Patient Office Visit, Level 3 | Active | $88.95 | — |
| 99214 Established Patient Office Visit, Level 4 | Active | $125.18 | — |
| 99202 New Patient Office Visit, Level 2 | Active | $69.87 | — |
| 99396 Preventive Exam, Established Patient, Age 40-64 | Non-covered | — | — |
| 99397 Preventive Exam, Established Patient, Age 65+ | Non-covered | — | — |
| 90471 Immunization Administration, First | Active | $20.05 | — |
| 96127 Brief Emotional/Behavioral Screening, Per Instrument | Active | $4.53 | — |
| 36415 Routine Venipuncture (Blood Draw) | Statutory exclusion | — | — |
Need a locality-adjusted rate or a specific setting? Use the rate calculator. Every code above also has its own page with a contracted-rate (% of Medicare) table and a full RVU breakdown.
These amounts shift with where you practice — local GPCIs move most of them a few percent either way. Browse Medicare payment localities or look up yours by ZIP code.
Model Primary Care's blended payer mix
Blended-rate modeling across a specialty's payer mix isn't built yet — it's on the roadmap, and how loudly primary care asks for it is part of what decides when.
Get notified when Primary Care rates change
Medicare updates the fee schedule every quarter. We'll email you when a release moves rates, tagged to Primary Care.
Did this answer your question about Primary Care?
We're building this out in the open. Tell us what you were actually trying to work out and we'll either answer you directly or build the page that does.
Source & method
National amounts computed from the CMS Medicare Physician Fee Schedule Q3 2025 release, GPCI 1.000, before the ~2% sequestration cut. This code list is our own clean-room grouping by common clinical scenario, not the AMA's code-family taxonomy. A code with no amount shown is either not separately payable under the PFS or was not in this release — never a fake $0.