Billing codes (CPT) and wRVUs

This information is obtained from the Medicare Physician Fee Schedule (MPFS) and third party sources for work Relative Value Units (wRVUs) for CPT® (Current Procedural Terminology) E/M (evaluation and management) billing codes. Please be aware that there seems to be variability in the content publicly available. Suggestions for additional resources are welcome.

Inpatient

E/M billing code	Service	wRVU	Time billing
99221	Initial hospital level care, level 1, straightforward/low medical decision making		30 minutes
99222	Initial hospital level care, level 2, moderate medical decision making		50 minutes
99223	Initial hospital level care, level 3, high medical decision making		70 minutes
99231	Subsequent hospital care, level 1, straightforward/low medical decision making		15 minutes
99232	Subsequent hospital care, level 2, moderate medical decision making		25 minutes
99233	Subsequent hospital care, level 3, high medical decision making		35 minutes
99251	Inpatient initial consultation, level 1, straightforward medical decision making		20 minutes
99252	Inpatient initial consultation, level 2, straightforward medical decision making		40 minutes
99253	Inpatient initial consultation, level 3, low medical decision making		55 minutes
99254	Inpatient initial consultation, level 4, moderate medical decision making		80 minutes
99255	Inpatient initial consultation, level 5, high medical decision making		110 minutes
99238	Inpatient discharge day management, up to 30 minutes		≤30 minutes
99239	Inpatient discharge day management, over 30 minutes		>30 minutes
99356	Inpatient prolonged service direct contact, first hour		30 to 60 minutes
99357	Inpatient prolonged service direct contact, additional 30 minutes		+30 minutes

Outpatient

E/M billing code	Service	wRVU	Time billing
99201	Office visit, new patient, level 1, straightforward medical decision making		10 minutes
99202	Office visit, new patient, level 2, straightforward medical decision making		20 minutes
99203	Office visit, new patient, level 3, low medical decision making		30 minutes
99204	Office visit, new patient, level 4, moderate medical decision making		45 minutes
99205	Office visit, new patient, level 5, high medical decision making		60 minutes
99212	Office visit, established patient, level 2, straightforward medical decision making		10 minutes
99213	Office visit, established patient, level 3, low medical decision making		15 minutes
99214	Office visit, established patient, level 4, moderate medical decision making		25 minutes
99215	Office visit, established patient, level 5, high medical decision making		40 minutes
99241	Office visit, new consult, level 1, straightforward medical decision making		15 minutes
99242	Office visit, new consult, level 2, straightforward medical decision making		30 minutes
99243	Office visit, new consult, level 3, low medical decision making		40 minutes
99244	Office visit, new consult, level 4, moderate medical decision making		60 minutes
99245	Office visit, new consult, level 5, high medical decision making		80 minutes

Observation

E/M billing code	Service	wRVU	Time billing
99218	Initial observation care, level 1, straightforward/low medical decision making
99219	Initial observation care, level 2, moderate medical decision making
99220	Initial observation care, level 3, high medical decision making
99224	Subsequent observation care, level 1, straightforward/low medical decision making
99225	Subsequent observation care, level 2, moderate medical decision making
99226	Subsequent observation care, level 3, high medical decision making
99217	Observation discharge day management
99234	Observation/inpatient care, admit & discharge on same date, level 1, low medical decision making
99235	Observation/inpatient care, admit & discharge on same date, level 2, moderate medical decision making
99236	Observation/inpatient care, admit & discharge on same date, level 3, high medical decision making

Skilled nursing facility (SNF)

E/M billing code	Service	wRVU	Time billing
99304	Initial nursing facility care, low complexity		25 minutes
99305	Initial nursing facility care, moderate complexity		35 minutes
99306	Initial nursing facility care, high complexity		45 minutes
99307	Subsequent nursing facility care, straightforward		10 minutes
99308	Subsequent nursing facility care, low complexity		15 minutes
99309	Subsequent nursing facility care, moderate complexity		25 minutes
99310	Subsequent nursing facility care, high complexity		35 minutes

Procedures

E/M billing code	Service	wRVU
38220	Bone marrow aspiration
38221	Bone marrow biopsy
96450	Chemotherapy injection into CNS (including intrathecal), requiring and including spinal puncture
96542	Chemotherapy injection, administration into subarachnoid or intraventricular space via subcutaneous reservoir, single or multiple agents
62270	Lumbar puncture, diagnostic spinal tap
62272	Lumbar puncture, therapeutic spinal tap for drainage of cerebrospinal fluid (CSF) by needle or catheter