Hospital · CMS status A
99253
Inpt/obs consult mod MDM 45 min
Inpatient or observation consultation, moderate-level medical decision making or 45 minutes total time. CMS 2026 wRVU 2.19.
Work RVU
2.19
2026 Medicare pays
$108.22
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 2.19 + Practice 0.88 + Malpractice 0.17 = 3.24 total
Work (your effort)Practice expenseMalpractice
Billing guidance for 99253 is locked
- When to use it: the exact clinical situations that support billing 99253
- Documentation checklist: the 3 elements your note needs before submitting
- Common pitfalls: the 2 mistakes that get 99253 downcoded or denied
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Common ICD-10 pairings
I48.91J18.9K72.10
Payer notes
Most common commercial-payer inpatient consult code. Documentation should support the MDM level explicitly.
Pairs well with
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.