PFS ExplorerMedicare Physician Fee Schedule · 2026

Search codes

Search for a command to run...

Model Your Practice

99214

Office o/p est mod 30 min

Add to my model
Code typePrimary
Payment statusActive (A)
Global periodNone

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary99214Office o/p est mod 30 min
1
$135.61
$84.50
Add-on15853Removal sutr/stapl xreq anes
0
$13.36/ unit
$13.36/ unit
Add-on15854Removal sutr&stapl xreq anes
0
$17.70/ unit
$17.70/ unit
Add-on90833Psytx w pt w e/m 30 min
0
$81.50/ unit
$65.80/ unit
Add-on90836Psytx w pt w e/m 45 min
0
$103.21/ unit
$83.17/ unit
Add-on90838Psytx w pt w e/m 60 min
0
$136.61/ unit
$110.22/ unit
Add-on96160Pt-focused hlth risk assmt
0
$3.01/ unit
$3.01/ unit
Add-on96161Caregiver health risk assmt
0
$3.34/ unit
$3.34/ unit
Add-on99415Prolng clin staff svc 1st hr
0
$23.05/ unit
$23.05/ unit
Add-on99459Pelvic examination
0
$17.37/ unit
$17.37/ unit
Add-onG0506Comp asses care plan ccm svc
0
$66.47/ unit
$38.41/ unit
Add-onG2211Complex e/m visit add on
0
$17.37/ unit
$14.36/ unit
Whole procedure · 1.92 wRVU credited
$135.61
$84.50

RVU Breakdown

Component
Office
Facility
Work
1.92
1.92
Practice expense
2.00
0.47
Malpractice
0.14
0.14
Total RVU
4.06
2.53

Payment Policy & Modifiers

Allowed adjustments
Assistant surgeon -80/81/8216% · documented
Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.
Not applicable to this code
Bilateral -50Multiple procedure Co-surgeon -62Team surgeon -66Prof / tech split