CPT code 99451: E-consult, written report, 5+ minutes2026 Medicare rate & RVUs in Colorado

A consulting physician reviews a patient's clinical information and sends written assessment and recommendations to the treating professional after at least five minutes of consultative work.

CMS RVU26DEffective Oct 1, 2026One payment locality106.7K Medicare services in 2024

In Colorado, Medicare pays $35.98 for 99451 in the office and $30.30 when it’s performed in a hospital or facility.

$35.98Office (non-facility)
$30.30Hospital or facility
+1.6%vs the national office rate ($35.40)

Check a contract rate as a % of Medicare · 99451 nationwide

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 99451 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Colorado
  2. What 99451 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 99451 covers

A treating physician or other qualified health care professional may request a specialist’s advice about a patient’s clinical question without arranging a patient visit with that specialist. The consultant reviews the relevant record and provides an assessment and recommendations in a written report. For example, a primary care physician might ask a cardiologist to review a patient’s symptoms and available cardiac test results and advise on next steps. The service is an exchange between professionals, not a face-to-face consultation with the patient.

Report 99451 when the consultative physician provides the written report and performs at least five minutes of medical consultative work. The record should identify the request and clinical question, information reviewed, consultant’s assessment and recommendations, written communication to the treating professional, and time spent. Document the patient’s consent to the interprofessional consultation. Distinguish this service from codes 99446–99449, which include verbal as well as written communication and use specific time intervals.

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 Colorado compares for 99451

Across 109 of 109 payment localities, the office rate for 99451 runs from $33.14 in Arkansas to $47.02 in Alaska. Colorado pays $35.98. The RVUs are the same everywhere; the geographic indexes change the dollars.

99451 in Colorado vs other payment areas
  1. Colorado · this page$35.98
  2. Los Angeles, CA · California$37.70+$1.72
  3. Washington, DC area · District of Columbia$38.70+$2.72
  4. Miami, FL · Florida$38.38+$2.40
  5. Chicago, IL · Illinois$37.78+$1.80
  6. Manhattan, NY · New York$39.56+$3.58
  7. Alaska · Alaska$47.02+$11.04

Other areas in Colorado first, then benchmark localities. Bars start at $0.

Every other payment area

99451 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$33.39$28.71
ArkansasArkansas$33.14$28.54
ArizonaArizona$34.84$29.67
Bakersfield, CACalifornia$36.19$30.33
Chico, CACalifornia$36.02$30.16
El Centro, CACalifornia$36.03$30.17
Fresno, CACalifornia$36.02$30.16
Hanford, CACalifornia$36.02$30.16

99451 rates by state

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

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$33.14

$47.02

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
99451 office rate range by state
State / territoryOffice rate rangeLocalities
AK$47.021
AL$33.391
AR$33.141
AZ$34.841
CA$36.02–$41.7829
CO$35.981
CT$37.021
DC$38.701
DE$35.231
FL$35.79–$38.383
GA$34.61–$35.982
GU$36.121
HI$36.121
IA$33.521
ID$33.701
IL$35.44–$37.784
IN$33.791
KS$33.581
KY$34.111
LA$34.14–$35.022
MA$35.99–$38.192
MD$35.63–$38.703
ME$33.95–$34.702
MI$34.72–$36.192
MN$34.531
MO$33.93–$34.913
MS$33.531
MT$35.401
NC$34.111
ND$34.411
NE$33.571
NH$35.621
NJ$37.45–$38.652
NM$34.881
NV$35.141
NY$34.39–$40.295
OH$34.521
OK$33.921
OR$34.87–$36.502
PA$34.46–$36.572
PR$35.491
RI$36.011
SC$34.371
SD$34.301
TN$33.691
TX$34.35–$36.158
UT$34.611
VA$34.74–$38.702
VI$35.491
VT$34.481
WA$35.86–$38.622
WI$33.811
WV$34.771
WY$34.971

See 99451 in every payment locality

How the 99451 rate is calculated

Each of 99451’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 · 99451

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.70

0.70 RVUs× 1.000 GPCI

Practice expense0.31

0.31 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

1.0600

Conversion factor

$33.4009

Medicare rate

$35.40

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

The exact Colorado inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,118

Code
99451
Physician work
0.70
Practice expense
0.31
Malpractice
0.05

GPCI2026.csv

37

Locality
Colorado
Physician work
1.012
Practice expense
1.064
Malpractice
0.781
Office calculation for 99451 in Colorado
ComponentRVULocality factorAdjusted
Physician work0.70× 1.0120.7084
Practice expense0.31× 1.0640.3298
Malpractice0.05× 0.7810.0391
Total RVUs1.0773
Conversion factor× 33.4009

Office rate, Colorado$35.98

Office: (0.7 × 1.012 + 0.31 × 1.064 + 0.05 × 0.781) × $33.4009 = $35.98

Facility: (0.7 × 1.012 + 0.15 × 1.064 + 0.05 × 0.781) × $33.4009 = $30.30

Open 99451 in the RVU calculator

Payment rules and modifiers for 99451

99451 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 99451

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$35.40

Non-facility (office)
$35.40
Facility
$30.06

Higher because the practice carries its own overhead.

How 99451 has changed in Colorado

99451 · Office / nonfacility

$35.98

Effective 2026-10-01

The base rate is $2.55 higher than on 2025-10-01, moving from $33.43 to $35.98 (7.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $33.43changed to$35.98

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.28 changed to 0.31
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.008 changed to 1.012
    • Practice expense GPCI 1.053 changed to 1.064
    • Malpractice GPCI 0.827 changed to 0.781

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $35.03changed to$33.43

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.29 changed to 0.28
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $34.46changed to$35.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $35.95changed to$34.46

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.31 changed to 0.29
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.005 changed to 1.008
    • Practice expense GPCI 1.050 changed to 1.053
    • Malpractice GPCI 0.797 changed to 0.827
  5. January 1, 2023

    RVU23A

    $36.45changed to$35.95

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.30 changed to 0.31
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.047 changed to 1.050
    • Malpractice GPCI 0.767 changed to 0.797

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $36.38changed to$36.45

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.29 changed to 0.30

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $37.71changed to$36.38

    • Conversion factor 36.0896 changed to 34.8931
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.033 changed to 1.047
    • Malpractice GPCI 0.905 changed to 0.767

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $37.74changed to$37.71

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 1.018 changed to 1.033
    • Malpractice GPCI 1.042 changed to 0.905

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$37.74

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$35.98$30.30RVU26D
2026-07-01$35.98$30.30RVU26C
2026-04-01$35.98$30.30RVU26B
2026-01-01$35.98$30.30RVU26A
2025-10-01$33.43$33.43RVU25D
2025-07-01$33.43$33.43RVU25C
2025-04-01$33.43$33.43RVU25B
2025-01-01$33.43$33.43RVU25A
2024-10-01$35.03$35.03RVU24D
2024-07-01$35.03$35.03RVU24C
2024-04-01$35.03$35.03RVU24B
2024-03-09$35.03$35.03RVU24AR
2024-01-01$34.46$34.46RVU24A
2023-10-01$35.95$35.95RVU23D
2023-07-01$35.95$35.95RVU23C
2023-04-01$35.95$35.95RVU23B
2023-01-01$35.95$35.95RVU23A
2022-10-01$36.45$36.45RVU22D
2022-07-01$36.45$36.45RVU22C
2022-04-01$36.45$36.45RVU22B
2022-01-01$36.45$36.45RVU22A
2021-10-01$36.38$36.38RVU21D
2021-07-01$36.38$36.38RVU21C
2021-04-01$36.38$36.38RVU21B
2021-01-01$36.38$36.38RVU21A
2020-10-01$37.71$37.71RVU20D
2020-07-01$37.71$37.71RVU20C
2020-04-01$37.71$37.71RVU20B
2020-01-01$37.71$37.71RVU20A
2019-10-01$37.74$37.74RVU19D
2019-07-01$37.74$37.74RVU19C
2019-04-01$37.74$37.74RVU19B
2019-01-01$37.74$37.74RVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 99451 for an earlier date of service

Where the Colorado rate applies

Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.

  • Acres Green
  • Aetna Estates
  • Aguilar
  • Air Force Academy
  • Akron
  • Alamosa
  • Alamosa East
  • Allenspark

Browse all communities in Colorado

99451 billing questions

When should 99451 be chosen instead of 99446?

Use 99451 when the consultant reports the assessment and recommendations in writing without the verbal discussion included in 99446. Both codes include a five-minute threshold, so the communication provided—not just elapsed time—distinguishes them.

Does 99451 require a discussion with the treating professional?

No. The service includes a written report to the treating or requesting professional; codes 99446–99449 describe services that include verbal and written communication.

What should the consultant document?

Document the referring professional’s question, records or clinical information reviewed, the assessment and recommendations, the written report, and at least five minutes of consultative work.

Is patient consent part of the documentation?

Yes. Document the patient’s consent to the interprofessional consultation.

Can 99451 be reported for less than five minutes?

No. The service requires at least five minutes of medical consultative time.

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

Show the CMS file lines behind this rate
RVUs for 99451PPRRVU2026_Oct_nonQPP.csv, line 13,118 (RVU26D)
Geographic factors for ColoradoGPCI2026.csv, line 37 (RVU26D)

Open CMS sourceHow we calculate rates

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