# CPT 99212: Established patient office/outpatient visit, straightforward medical decision making

Medicare CPT 99212 pays $59.45 in a non-facility setting and $31.06 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $53.68 in Arkansas to $72.46 in Alaska, a 35% spread.

Web page: https://www.med-reveal.com/rates/99212-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Allergy & Immunology, Cardiovascular Disease, Child & Adolescent Psychiatry, Clinic/Center, Clinical Genetics (M.D.), Dermatology, Endocrinology, Evaluation, Family Medicine, Gastroenterology, Hematology & Oncology, Infectious Disease, Internal Medicine, Methadone Clinic, Neurological Surgery, Neurology, Obstetrics & Gynecology, Ophthalmology, Optometrist, Otolaryngology, Pain Medicine, Pediatrics, Plastic Surgery, Psychiatry & Neurology, Pulmonary Disease, Rheumatology, Sleep Medicine, Sports Medicine, Thoracic Surgery (Cardiothoracic Vascular Surgery), Urology, Vascular Surgery

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $59.45 |
| National facility | $31.06 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $72.46 | $42.22 |
| District of Columbia | $67.01 | $33.56 |
| California | $65.62 | $32.03 |
| New York | $65.22 | $33.55 |
| New Jersey | $65.12 | $33.14 |
| Washington | $64.54 | $32.17 |
| Massachusetts | $64.02 | $32.11 |
| Hawaii | $63.28 | $31.00 |
| Connecticut | $62.97 | $32.39 |
| Colorado | $61.48 | $31.27 |
| Florida | $61.46 | $32.98 |
| Maryland | $61.36 | $31.77 |
| Oregon | $60.91 | $31.00 |
| Rhode Island | $60.81 | $31.48 |
| New Hampshire | $60.60 | $31.05 |
| Illinois | $60.21 | $32.78 |
| Puerto Rico | $59.80 | $31.10 |
| Virgin Islands | $59.80 | $31.10 |
| Montana | $59.45 | $31.06 |
| Nevada | $59.15 | $30.73 |
| Pennsylvania | $59.11 | $31.30 |
| Minnesota | $59.03 | $29.82 |
| Delaware | $58.96 | $30.91 |
| Wyoming | $58.93 | $30.54 |
| Texas | $58.91 | $30.96 |
| Georgia | $58.32 | $31.23 |
| Virginia | $58.29 | $30.38 |
| North Dakota | $58.26 | $29.87 |
| Michigan | $58.20 | $31.54 |
| South Dakota | $58.12 | $29.73 |
| Vermont | $58.12 | $30.02 |
| Arizona | $58.11 | $30.60 |
| Utah | $57.21 | $30.52 |
| Maine | $57.19 | $30.06 |
| New Mexico | $57.03 | $30.99 |
| Wisconsin | $56.64 | $29.44 |
| Missouri | $56.62 | $30.56 |
| Louisiana | $56.59 | $30.67 |
| South Carolina | $56.56 | $30.33 |
| Ohio | $56.51 | $30.58 |
| North Carolina | $56.45 | $29.96 |
| Indiana | $55.94 | $29.62 |
| West Virginia | $55.85 | $31.18 |
| Idaho | $55.67 | $29.55 |
| Nebraska | $55.58 | $29.38 |
| Kentucky | $55.50 | $30.26 |
| Tennessee | $55.43 | $29.62 |
| Oklahoma | $55.36 | $30.01 |
| Iowa | $55.35 | $29.37 |
| Kansas | $55.19 | $29.52 |
| Alabama | $54.33 | $29.48 |
| Mississippi | $54.19 | $29.75 |
| Arkansas | $53.68 | $29.29 |

## Related codes

- 99211: Established patient office/outpatient visit, may not require physician presence — https://www.med-reveal.com/rates/99211-cpt-fee-schedule
- 99213: Established patient office/outpatient visit, low medical decision making — https://www.med-reveal.com/rates/99213-cpt-fee-schedule
- 99214: Established patient office/outpatient visit, moderate medical decision making — https://www.med-reveal.com/rates/99214-cpt-fee-schedule
- 99215: Established patient office/outpatient visit, high medical decision making — https://www.med-reveal.com/rates/99215-cpt-fee-schedule

Commercial negotiated rates for 99212 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules