99255 inpatient/obs consltj new/established hi 80
Also known as: complex hospital consultation, high complexity consult, comprehensive hospital consult
Inpatient or observation hospital consultations for a new or established patient with high medical decision-making complexity and an expected time of 80 minutes.
Clinical Context
Used for hospital or observation consultations with high medical decision-making complexity, requiring comprehensive evaluation and recommendations for complex, multi-system acute problems in hospitalized patients.
RVU Breakdown
| Work RVU | 3.86 |
| Practice Expense RVU | 1.44 |
| Malpractice RVU | 0.23 |
| Total RVU | 5.53 |
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.