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99205 Office outpatient new hi 60 minutes

E&M

Also known as: complex office visit, comprehensive follow-up, high complexity visit, new patient office visit level 5, high complexity new visit

Office or other outpatient visit for the evaluation and management of an established patient with high medical decision-making complexity and an expected duration of 60 minutes.

Clinical Context

Used for established patient visits involving high complexity medical decision-making, such as management of multiple acute and chronic conditions with complex diagnostic and therapeutic planning.

RVU Breakdown

Work RVU3.50
Practice Expense RVU3.23
Malpractice RVU0.36
Total RVU7.09

Est. Medicare Payment

$236.81

National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).

Specialties

Family MedicineInternal MedicineSubspecialties

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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.