99252 inpatient/obs consltj new/established sf 35
Also known as: hospital consultation, inpatient consult, hospital specialist visit
Inpatient or observation hospital consultations for a new or established patient with straightforward medical decision-making complexity and an expected time of 35 minutes.
In Plain Language
Hospital specialist consultation; Inpatient doctor referral
Clinical Context
Used for consultations provided to hospitalized or observation patients by a physician who is requested to evaluate specific problems with straightforward medical decision-making complexity.
RVU Breakdown
| Work RVU | 1.50 |
| Total RVU | 1.50 |
Est. Medicare Payment
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 1.50, this code ranks in the 50th percentile among Evaluation & Management codes — 1.0x below the median (1.54). The highest wRVU in this category is 18.46.
Specialties
Frequently Asked Questions
What is CPT code 99252?
CPT 99252 (inpatient/obs consltj new/established sf 35) is a Evaluation & Management code. Inpatient or observation hospital consultations for a new or established patient with straightforward medical decision-making complexity and an expected time of 35 minutes.
Who uses CPT code 99252?
CPT 99252 is used by Specialist Physicians, Hospital Medicine. Used for consultations provided to hospitalized or observation patients by a physician who is requested to evaluate specific problems with straightforward medical decision-making complexity.
When is CPT 99252 used?
Used for consultations provided to hospitalized or observation patients by a physician who is requested to evaluate specific problems with straightforward medical decision-making complexity.
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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.