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99213 Office outpatient established low 20 minutes

Evaluation & Management

Also known as: office visit, low complexity visit, established patient, established patient office visit level 3, standard office visit, follow-up visit, return visit, follow up visit, routine office visit

Office or other outpatient visit for the evaluation and management of an established patient with low medical decision-making complexity and an expected duration of 20 minutes.

In Plain Language

Standard doctor's visit; Regular appointment

Clinical Context

Used for established patient office visits with low medical decision-making complexity, such as routine visits for stable chronic disease management or follow-up of minor acute conditions.

RVU Breakdown

Work RVU1.30
Total RVU1.30

Est. Medicare Payment

$43.42

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

Billing & Documentation

E&M codes require documentation of medical decision-making (MDM) complexity or total time spent on the encounter. For 2026, time-based coding includes all physician time on the date of the encounter.

How This Code Compares

With a work RVU of 1.30, this code ranks in the 38th percentile among Evaluation & Management codes — 1.2x below the median (1.54). The highest wRVU in this category is 18.46.

Specialties

Family MedicineInternal MedicinePrimary Care

Frequently Asked Questions

What is CPT code 99213?

CPT 99213 (Office outpatient established low 20 minutes) is a Evaluation & Management code. Office or other outpatient visit for the evaluation and management of an established patient with low medical decision-making complexity and an expected duration of 20 minutes.

Who uses CPT code 99213?

CPT 99213 is used by Family Medicine, Internal Medicine, Primary Care. Used for established patient office visits with low medical decision-making complexity, such as routine visits for stable chronic disease management or follow-up of minor acute conditions.

When is CPT 99213 used?

Used for established patient office visits with low medical decision-making complexity, such as routine visits for stable chronic disease management or follow-up of minor acute conditions.

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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.