99215 Office outpatient established hi 40 minutes
Also known as: complex office visit, high complexity, comprehensive visit, established patient office visit level 5, high complexity visit, complex 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 40 minutes.
Clinical Context
Used for established patient office visits requiring high medical decision-making complexity, such as new diagnosis of significant condition, complex medication adjustments, or management of multiple acute and chronic conditions.
RVU Breakdown
| Work RVU | 2.80 |
| Practice Expense RVU | 2.75 |
| Malpractice RVU | 0.21 |
| Total RVU | 5.76 |
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.