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

Elgin, TX spans 2 Medicare payment localities (Rest of State, Austin). Compare 2026 rates and find the locality for your ZIP.

CMS RVU26DEffective Oct 1, 20262 payment localities

CMS doesn’t publish an office rate for 99417 in Elgin, Texas.

—Office (non-facility)
—Hospital or facility

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

We’ll open 99417 for the payment locality that covers the ZIP.

On this page 6 sections
  1. Rate in Elgin, Texas
  2. By payment locality
  3. City and payment areas
  4. How it’s calculated
  5. Payment rules
  6. Sources

Where 99417 pays more and less in Elgin, Texas

Elgin, Texas maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.

99417 office and facility rates by payment locality
Payment localityOfficeFacility
Austin, TXUnavailableUnavailable
Rest of TexasUnavailableUnavailable

How payment areas work in Elgin

City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.

  • Rest Of State · Bastrop County
  • Austin · Travis County

City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions

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.

How the rate is built · 99417

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.61

0.61 RVUs× 1.000 GPCI

Practice expense0.31

0.31 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

0.9600

Conversion factor

$33.4009

Medicare rate

$32.06

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 99417

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

CMS payment indicators · 99417

Prolonged E/M, office or outpatient

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures9The concept doesn’t apply.
Bilateral (modifier 50)9The concept doesn’t apply.
Assistant at surgery (80/81/82/AS)9The concept doesn’t apply.
Co-surgeons (62)9The concept doesn’t apply.
Team surgery (66)9The concept doesn’t apply.
Professional/technical9The concept doesn’t apply.

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

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