99204 Office outpatient new mod 45 minutes
Also known as: moderate complexity office visit, established patient visit, new patient office visit level 4, moderate complexity new visit
Office or other outpatient visit for the evaluation and management of an established patient with moderate medical decision-making complexity and an expected duration of 45 minutes.
Clinical Context
Used for established patient office visits requiring moderate medical decision-making, such as management of multiple chronic conditions or more complex acute illness presentations.
RVU Breakdown
| Work RVU | 2.60 |
| Practice Expense RVU | 2.47 |
| Malpractice RVU | 0.24 |
| Total RVU | 5.31 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Specialties
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.