Office & outpatient visits

99211 - RVUs & Medicare payment (2026)

Office visit, established patient, level 1 (minimal, staff-level).

Component	Non-facility	Facility
Work RVU	0.18	0.18
Practice expense RVU	0.54	0.04
Malpractice RVU	0.01	0.01
Total RVUs	0.73	0.23
National payment (CF $33.4009)	$24.38	$7.68
Qualifying APM payment (CF $33.5675)	$24.50	$7.72

How 99211 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 99211 ranges from $21.68 in Arkansas (AR) to $32.86 in San Jose-Sunnyvale-Santa Clara (CA); calculate 99211 for your locality.

San Jose-Sunnyvale-Santa Clara (CA) $32.86 San Jose-Sunnyvale-Santa Clara (CA) $32.81 San Francisco-Oakland-Berkeley (CA) $32.17 San Francisco-Oakland-Berkeley (CA) $32.16 Napa (CA) $30.33 Vallejo (CA) $30.32 Seattle (WA) $28.72 Santa Rosa-Petaluma (CA) $28.52 National average $24.38 … 97 more localities between … Alabama (AL) $21.98 Rest Of Missouri (MO) $21.88 Mississippi (MS) $21.79 Arkansas (AR) $21.68

Non-facility payment for 99211 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: XXX

No global period: the global surgery concept does not apply to this code.

Related codes - office & outpatient visits

99202 · office visit, new patient, level 2 (straightforward, 15-29 min)
99203 · office visit, new patient, level 3 (low complexity, 30-44 min)
99204 · office visit, new patient, level 4 (moderate complexity, 45-59 min)
99205 · office visit, new patient, level 5 (high complexity, 60-74 min)
99212 · office visit, established patient, level 2 (straightforward, 10-19 min)
99213 · office visit, established patient, level 3 (low complexity, 20-29 min)
99214 · office visit, established patient, level 4 (moderate complexity, 30-39 min)
99215 · office visit, established patient, level 5 (high complexity, 40-54 min)
G2212 · medicare prolonged visit add-on, each additional 15 minutes
G2211 · medicare add-on for visit complexity in continuing, longitudinal care

Frequently asked questions

How much does Medicare pay for 99211 in 2026?

The national non-facility payment is $24.38 and the facility payment is $7.68, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.

What is the work RVU for 99211?

The 2026 work RVU for 99211 is 0.18. Total RVUs are 0.73 in the non-facility setting and 0.23 in the facility setting.

Why are the facility and non-facility amounts different?

Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.