Billing codes (CPT) and wRVUs

This information is obtained from the Medicare Physician Fee Schedule (MPFS) and third party sourcesMedicare Physician Fee Schedule (MPFS)Happy Hospitalist - Work (wRVU) and Total (tRVU) List For Hospitalist E/M CPT® Codes 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 	 	2021 and on: 15-29 minutes overall time (Before 2021: at least 20 minutes with patient)
99203 	Office visit, new patient, level 3, low medical decision making 	 	2021 and on: 30-44 minutes overall time (Before 2021: at least 30 minutes with patient)
99204 	Office visit, new patient, level 4, moderate medical decision making 	 	2021 and on: 45-59 minutes overall time (Before 2021: at least 45 minutes with patient)
99205 	Office visit, new patient, level 5, high medical decision making 	 	2021 and on: 60-74 minutes overall time (Before 2021: at least 60 minutes with patient)
99212 	Office visit, established patient, level 2, straightforward medical decision making 	 	2021 and on: 10-19 minutes overall time (Before 2021: at least 10 minutes with patient)
99213 	Office visit, established patient, level 3, low medical decision making 	 	2021 and on: 20-29 minutes overall time (Before 2021: at least 15 minutes with patient)
99214 	Office visit, established patient, level 4, moderate medical decision making 	 	2021 and on: 30-39 minutes overall time (Before 2021: at least 25 minutes with patient)
99215 	Office visit, established patient, level 5, high medical decision making 	 	2021 and on: 40-54 minutes overall time (Before 2021: at least 40 minutes with patient)
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
99417 	Outpatient prolonged office or other outpatient evaluation and management service(s) (beyond the total time of the primary procedure which has been selected using total time)	 	every (at least) 15 minutes total time beyond maximum time for outpatient new patient or established patient time-based billing
99354 	Outpatient prolonged service direct contact, first hour 	 	30 to 60 minutes
+99355 	Outpatient prolonged service direct contact, additional 30 minutes 	 	+30 minutes
99358 	Outpatient non face-to-face prolonged service before and/or after direct patient care, first hour 	 	31 to 60 minutes
+99359 	Outpatient non face-to-face prolonged service before and/or after direct patient care, each additional 30 minutes 	 	+30 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 	 	
==Advance care planning (ACP)==
E/M billing code	Service 	wRVU	Time billing
99497 	Advance care planning, face-fo-face time, first 30 minutes 	 	16 to 30 minutes
+99498 	Advance care planning, face-fo-face time, additional 30 minutes	 	+30 minutes
==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 	
==References==
Category:General reference pages