CPT Code 99204 - 2025 RVU Values

Complete RVU breakdown for 99204 including work RVUs, practice expense, malpractice, and total RVU values for 2025.

Last updated: January 15, 2025

99204E/M

Description

Office o/p new mod 45 min

Specialty Category

Patient encounters and consultations

Common Specialties: Primary Care, Hospitalist, Internal Medicine

2025 RVU Breakdown

Work RVU

Physician time and effort

2.60

Practice Expense RVU

Equipment and overhead costs

2.21

Malpractice RVU

Professional liability costs

0.24

Total RVU

Sum of all components

5.05

Frequently Asked Questions About CPT 99204

How many wRVUs is 99204 in 2025?

CPT code 99204 has 2.60 work RVUs in 2025according to the CMS Physician Fee Schedule.

The total RVU value including all components is 5.05 RVUs.

What type of procedure is 99204?

99204 is classified as E/M: Office o/p new mod 45 min

This procedure is commonly used by: Primary Care, Hospitalist, Internal Medicine

How do I calculate total compensation for 99204?

To calculate compensation: Work RVUs (2.60) × Your wRVU Rate × Geographic Adjustment Factor

Use our calculator below to estimate RVU values for multiple quantities.

Clinical Usage Guidelines for 99204

Documentation Requirements

Important: Proper documentation is required to support billing for 99204. Ensure your documentation meets CMS guidelines and local carrier policies.

Common Modifiers

-25Significant, separately identifiable E/M

-57Decision for surgery

Compare E/M Codes

CPT Code	Description	Work RVU	Total RVU	Difference
99202	Office o/p new sf 15 min	0.93	2.16	-1.67
99203	Office o/p new low 30 min	1.60	3.37	-1.00
99204	Office o/p new mod 45 min	2.60	5.05	0.00
99205	Office o/p new hi 60 min	3.50	6.67	+0.90
99211	Off/op est may x req phy/qhp	0.18	0.70	-2.42