# CPT 99215: Established patient office/outpatient visit, high medical decision making

Medicare CPT 99215 pays $192.39 in a non-facility setting and $125.59 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $176.04 in Arkansas to $241.97 in Alaska, a 37% spread.

Web page: https://www.med-reveal.com/rates/99215-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, General Surgery, Hematology & Oncology, Infectious Disease, Internal Medicine, Methadone Clinic, Neurological Surgery, Neurology, Obstetrics & Gynecology, Ophthalmology, Optometrist, Orthopaedic Surgery, 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 | $192.39 |
| National facility | $125.59 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $241.97 | $170.83 |
| District of Columbia | $214.58 | $135.89 |
| New York | $209.96 | $135.44 |
| California | $209.36 | $130.32 |
| New Jersey | $209.36 | $134.14 |
| Washington | $206.72 | $130.56 |
| Massachusetts | $205.30 | $130.25 |
| Connecticut | $202.81 | $130.86 |
| Hawaii | $202.02 | $126.07 |
| Florida | $199.34 | $132.31 |
| Maryland | $198.05 | $128.41 |
| Colorado | $197.85 | $126.78 |
| Rhode Island | $196.44 | $127.43 |
| Oregon | $196.12 | $125.74 |
| Illinois | $196.01 | $131.46 |
| New Hampshire | $195.28 | $125.74 |
| Puerto Rico | $193.29 | $125.76 |
| Virgin Islands | $193.29 | $125.76 |
| Montana | $192.38 | $125.57 |
| Pennsylvania | $191.83 | $126.40 |
| Nevada | $191.31 | $124.44 |
| Delaware | $191.05 | $125.05 |
| Texas | $190.98 | $125.21 |
| Wyoming | $190.57 | $123.76 |
| Minnesota | $190.11 | $121.38 |
| Georgia | $189.69 | $125.96 |
| Michigan | $189.65 | $126.92 |
| Virginia | $188.77 | $123.10 |
| Arizona | $188.53 | $123.80 |
| North Dakota | $188.22 | $121.42 |
| Vermont | $188.01 | $121.87 |
| South Dakota | $187.73 | $120.93 |
| New Mexico | $186.18 | $124.92 |
| Utah | $186.16 | $123.37 |
| Maine | $185.68 | $121.85 |
| Louisiana | $184.73 | $123.74 |
| Missouri | $184.71 | $123.42 |
| Ohio | $184.45 | $123.46 |
| South Carolina | $184.36 | $122.63 |
| North Carolina | $183.70 | $121.38 |
| Wisconsin | $183.68 | $119.68 |
| West Virginia | $183.38 | $125.33 |
| Indiana | $182.08 | $120.15 |
| Kentucky | $181.60 | $122.21 |
| Idaho | $181.34 | $119.89 |
| Oklahoma | $181.00 | $121.34 |
| Nebraska | $180.95 | $119.30 |
| Tennessee | $180.78 | $120.06 |
| Iowa | $180.35 | $119.23 |
| Kansas | $180.09 | $119.70 |
| Alabama | $177.86 | $119.41 |
| Mississippi | $177.79 | $120.27 |
| Arkansas | $176.04 | $118.65 |

## Related codes

- 99211: Established patient office/outpatient visit, may not require physician presence — https://www.med-reveal.com/rates/99211-cpt-fee-schedule
- 99212: Established patient office/outpatient visit, straightforward medical decision making — https://www.med-reveal.com/rates/99212-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

Commercial negotiated rates for 99215 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