Outpatient IM
Internal Medicine
The bread and butter: established office visits, new-patient workups, complex chronic disease bundles, and wellness add-ons. The codes that move primary care RVUs are E/M time/MDM, G2211, and the wellness stack.
Top billed codes
The codes that drive revenue in this specialty. Click any code for documentation requirements, modifiers, and pitfalls.
| Code | Description | wRVU | Total RVU | Medicare $ | |
|---|---|---|---|---|---|
| 99213 | Office o/p est low 20 min Stable established patient, one or two minor problems, simple lab review, no medication changes. Examples: stable HTN follow-up, routine refills, simple URI. | 1.30 | 2.85 | $95 | Details → |
| 99214 | Office o/p est mod 30 min The workhorse code. Two or more chronic problems with progression/treatment changes, OR one undiagnosed new problem with uncertain prognosis, OR prescription drug management. | 1.92 | 4.06 | $136 | Details → |
| 99215 | Office o/p est hi 40 min Severe exacerbation, decompensated chronic illness, decision regarding hospitalization, or extensive comorbidity management requiring high-risk decision-making. | 2.80 | 5.76 | $192 | Details → |
| 99204 | Office o/p new mod 45 min New patient with a moderately complex problem requiring comprehensive history, exam, and drug management. The default new-patient code in primary care and most subspecialties. | 2.60 | 5.31 | $177 | Details → |
| 99205 | Office o/p new hi 60 min New patient with severe, decompensated, or high-acuity disease. Complex consult-style new patient encounters. | 3.50 | 7.09 | $237 | Details → |
| G2211 | Complex e/m visit add on Add-on to office E/M (99202-99215) when you are the continuing focal point for all needed care (primary care) OR the ongoing care provider for a single serious/complex condition. | 0.33 | 0.52 | $17 | Details → |
| 99497 | Advncd care plan 30 min Discussion of advance directives, healthcare proxy, goals of care. Patient must be present at start unless meeting with a surrogate is explicitly billed. | 1.50 | 2.60 | $87 | Details → |
| G0444 | Depression screen annual Annual Medicare benefit. Must use a validated tool with the score documented. | 0.18 | 0.56 | $19 | Details → |
| G0537 | Risk ascvd tst once pr 12 mo Annual ASCVD risk calculation in patients without known ASCVD. New 2025 code; pairs naturally with AWV. | 0.18 | 0.60 | $20 | Details → |
| 99406 | Behav chng smoking 3-10 min Counseling a tobacco user about cessation. 3-10 min = 99406, >10 min = 99407. | 0.24 | 0.46 | $15 | Details → |
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Educational reference, not billing or legal advice. Coverage curated, not exhaustive. Verify against payer contracts.