CPT Guides

CPT 99202 RVU Guide for New Patient Visits

A focused 2026 guide to CPT 99202 work RVU, total RVU, Medicare payment, setting differences, and new patient E/M comparisons.

Reviewed
2026-06-29
Updated
2026-06-29
Source
CMS 2026 RVU and GPCI source context

Interpret then calculate

Keep the article as the explanation layer and move into the related tool only after the relevant CPT, locality, or benchmark assumption is clear.

Use when
You are reading about CPT 99202 RVU and need to apply it to a concrete RVU workflow.
Source role
Hand-reviewed article copy plus related tool links keep assumptions traceable.
Boundary
This article is not the calculator output, coding advice, payer adjudication, or contract review.

CPT 99202 is a straightforward new patient office or outpatient E/M code. In the imported 2026 CMS RVU data set used by RVUinUSA, 99202 carries 0.93 work RVU, 1.25 non-facility practice expense RVU, 0.23 facility practice expense RVU, and 0.07 malpractice RVU before GPCI and conversion factor assumptions. It is the low-end new patient reference code for access, intake, and compensation modeling where payment, productivity, and coding boundaries need to stay separate. This page explains the RVU and payment effect after 99202 is supported by documentation and payer rules; it is not coding advice and does not determine whether a specific visit should be coded as 99202.

99202 in the 2026 RVU data set

The imported 2026 descriptor for 99202 is a straightforward new patient office or outpatient visit with a 15-minute reference descriptor. For RVU modeling, the important components are 0.93 work RVU, 1.25 non-facility practice expense RVU, 0.23 facility practice expense RVU, and 0.07 malpractice RVU. These values can support payment estimates, productivity review, and contract modeling only after the E/M level is independently supported. RVU values explain economics after code selection; they do not select the code.

  • Work RVU: 0.93.
  • Non-facility PE RVU: 1.25; facility PE RVU: 0.23.
  • Malpractice RVU: 0.07.

CPT 99202 2026 RVU components

Values from the imported 2026 CMS RVU data set used by RVUinUSA. Payment estimates require setting, locality, and conversion factor assumptions.

CPTDescriptorWork RVUNon-facility PEFacility PEMP RVU
99202New patient office/outpatient visit, straightforward reference descriptor0.931.250.230.07

RVU values describe financial and productivity inputs after code selection. They are not coding advice.

How this connects to RVU payment

GPCI is applied component by component. A locality comparison is only meaningful when the CPT code, setting, and participant status stay fixed.

Locality-adjusted RVU formula
(Work RVU x Work GPCI) + (PE RVU x PE GPCI) + (MP RVU x MP GPCI)
Assumptions
Code input
CPT/HCPCS
Setting input
Facility or office
Output
Adjusted total RVU

National total RVU and payment estimate

At national GPCI values, 99202 has a non-facility total RVU of 2.25 and a facility total RVU of 1.23. Using the 2026 non-QPP conversion factor of $33.4009, that produces an estimated national non-facility Medicare payment of about $75.15 and an estimated national facility payment of about $41.08. The setting difference is driven by practice expense RVU because work RVU and malpractice RVU stay the same. A professional estimate should keep CPT code, setting, locality, data year, and QPP status visible beside the dollar result.

  • National non-facility total RVU: 2.25; non-QPP estimate about $75.15.
  • National facility total RVU: 1.23; non-QPP estimate about $41.08.
  • QPP/APM status changes the final multiplier, not the CPT RVU components.

National 99202 payment model

Use 1.25 PE RVU for non-facility estimates and 0.23 PE RVU for facility estimates before locality GPCI adjustment.

Formula
Payment = (0.93 work RVU + selected PE RVU + 0.07 MP RVU) x 2026 conversion factor

Compare 99202 with adjacent new patient codes

99202 is most useful when compared with 99203, 99204, and 99205 under the same assumptions. That comparison can clarify the payment and productivity spread across new patient office or outpatient levels, but it should not be used to choose a code. In national non-facility assumptions, 99202 totals 2.25 RVU, 99203 totals 3.52 RVU, 99204 totals 5.31 RVU, and 99205 totals 7.09 RVU. RVUinUSA's role is to show the economics once the coding basis is established.

  • 99202: 0.93 work RVU and 2.25 national non-facility total RVU.
  • 99203: 1.60 work RVU and 3.52 national non-facility total RVU.
  • 99204: 2.60 work RVU and 5.31 national non-facility total RVU.

New patient E/M comparison

National non-facility comparison using imported 2026 RVU components before locality adjustment.

CPTWork RVUNon-facility total RVUNon-QPP estimateUse case
992020.932.25$75.15Straightforward new patient visit context
992031.603.52$117.57Lower-intensity new patient visit context
992042.605.31$177.36Moderate new patient visit context
992053.507.09$236.81Higher-intensity new patient visit context

The table is an RVU comparison. It does not determine the correct E/M level for a specific patient encounter.

Keep new patient and established patient comparisons separate

Searchers may compare 99202 with 99212 or 99213 because all are lower-level office E/M codes, but they do not answer the same coding question. 99202 is a new patient visit code, while 99212 and 99213 are established patient visit codes. In the 2026 RVU data, 99202 carries 0.93 work RVU and 2.25 national non-facility total RVU. 99212 carries 0.70 work RVU and 1.78 national non-facility total RVU, while 99213 carries 1.30 work RVU and 2.85 national non-facility total RVU. Those spreads explain economics only after the visit family and code level are supported, and the RVU comparison does not replace E/M documentation, payer, or compliance review.

  • 99202 is a new patient E/M code; 99212 and 99213 are established patient E/M codes.
  • Compare RVU values only after the correct visit family is known.
  • Use RVU output to interpret economics, not to convert one visit type into another.
Coding boundary: A lower or higher RVU value does not make 99202 appropriate. RVUinUSA explains payment and productivity impact after the code is supported; it does not replace E/M documentation, payer, or compliance review.

Use 99202 carefully in productivity and contract review

For physician compensation, 99202 contributes 0.93 work RVU when the employment agreement credits the service. The annual impact depends on legitimate new patient volume, schedule design, referral pattern, payer mix, dollars-per-wRVU rate, threshold, excluded services, modifier handling, and whether the contract uses the same CMS RVU schedule as the calculator. Low-intensity new patient access can still matter at scale, but Medicare payment and employment compensation remain different models. Medicare payment uses total RVU, GPCI, and conversion factor assumptions; employment compensation usually uses credited work RVU and written contract rules.

  • Use 0.93 wRVU for productivity modeling only when the contract credits 99202.
  • Separate Medicare payment estimates from employment compensation calculations.
  • Review whether the contract freezes RVU values to a specific CMS schedule year.

Run 99202 through RVUinUSA tools

The practical workflow is to open the 99202 CPT page, confirm the imported 2026 RVU components, run the RVU calculator with the correct setting and GPCI locality, and compare adjacent new patient codes only under the same assumptions. If the question is compensation, use the salary estimator or contract analyzer after the code mix and credited wRVU rules are known. If the question is payment, keep setting, locality, QPP status, and conversion factor visible with the result.

  • Use /cpt/99202 for code-level RVU components.
  • Use the RVU calculator for same-assumption payment estimates.
  • Use contract tools only after the written productivity rules are clear.

FAQs

What is the 2026 wRVU for CPT 99202?

The imported 2026 CMS RVU data set used by RVUinUSA lists 0.93 work RVU for CPT 99202.

What is the national non-facility total RVU for 99202?

At national GPCI values, 99202 has a non-facility total RVU of 2.25 before the conversion factor is applied.

What is the estimated 2026 Medicare payment for 99202?

Using national GPCI values and the 2026 non-QPP conversion factor of $33.4009, 99202 estimates to about $75.15 in the non-facility setting and about $41.08 in the facility setting.

How does 99202 compare with 99203?

In the imported 2026 data set, 99202 has 0.93 work RVU and 99203 has 1.60 work RVU. Under national non-facility assumptions, 99202 estimates to about $75.15 and 99203 estimates to about $117.57 before locality differences.

Can this page tell me whether to bill 99202?

No. This page explains RVU and payment inputs after code selection. E/M coding requires documentation, medical decision making or time rules when applicable, payer policy, and compliance review.