CPT code 99427: Principal care management, additional clinical staff time2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $60.69 for 99427 in the office and $33.94 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 99427 nationwide

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

What 99427 covers

This code covers an additional 30 minutes of clinical staff work in principal care management for a patient with a single serious, complex chronic condition. The work centers on the condition-specific care plan and may include coordinating care with other clinicians, supporting medication management, and following up on changes that affect the patient’s disease. Clinical staff perform the work under a physician’s or other qualified health care professional’s direction, commonly as part of outpatient care for a condition that creates substantial risk of worsening or functional decline.

Report 99427 only after the initial clinical staff principal care management interval is represented by 99426. The record should identify the condition and care plan, describe the staff activities, and support the additional time counted during the calendar month. CMS classifies 99427 as an add-on code: it must be billed with a primary procedure and is paid within that procedure’s global period.

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.

How Washington, DC area compares for 99427

Across 109 of 109 payment localities, the office rate for 99427 runs from $49.25 in Arkansas to $68.64 in San Benito County, CA. Washington, DC area pays $60.69. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99427 rates by state

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

See 99427 in every payment locality

How the 99427 rate is calculated

Each of 99427’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 99427

The CMS indicators that decide how 99427 is paid alongside other services.

Codes related to 99427

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

How 99427 has changed in Washington, DC area

Price 99427 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

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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