CPT code 99417: Prolonged E/M, office or outpatient2026 Medicare rate & RVUs

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 99417 covers

CPT 99417 represents additional physician or qualified health professional time spent on a qualifying office or other outpatient evaluation and management service. It is an add-on to the primary E/M service, not a stand-alone visit code. The clinician’s prolonged work is associated with the outpatient encounter; this code is distinct from prolonged services provided by clinical staff and from prolonged inpatient or observation E/M services.

Each unit represents a 15-minute increment. The record should support the qualifying outpatient E/M service and the additional clinician time reported. Medicare assigns 99417 status I under the physician fee schedule: Medicare does not accept this code for reporting and payment. For Medicare prolonged office or outpatient E/M reporting, use G2212 instead.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 99417 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

99417 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 99417 rate is calculated

Each of 99417’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 99417

The CMS indicators that decide how 99417 is paid alongside other services.

99417 compared with similar codes

How to choose

G2212Prolonged office visitMedicare add-on, each 15 minutes

99417 is the CPT code for prolonged office or outpatient E/M time, but Medicare does not accept it. Medicare uses G2212 for this reporting purpose.

99418Prolonged E/MInpatient or observation

99418 applies to prolonged inpatient or observation E/M services; 99417 is for office or other outpatient E/M services.

99415Prolonged staff careFirst hour, outpatient E/M

99415 reports prolonged clinical staff services, not additional time personally spent by the physician or qualified health professional.

99416Prolonged staff serviceEach additional time unit

99416 is an additional prolonged clinical staff service code; 99417 represents prolonged physician or qualified health professional time.

Codes related to 99417

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates