Billing code 99243Medicare rate & RVUs in Texas
Compare 99243 physician payment amounts across CMS localities, including office and facility settings.
CMS doesn’t publish an office rate for 99243 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 5 sections
Where 99243 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | Unavailable |
| Beaumont | Unavailable | Unavailable |
| Brazoria | Unavailable | Unavailable |
| Dallas | Unavailable | Unavailable |
| Fort Worth | Unavailable | Unavailable |
| Galveston | Unavailable | Unavailable |
| Houston | Unavailable | Unavailable |
| Rest Of Texas | Unavailable | Unavailable |
How the 99243 rate is calculated
Each of 99243’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 · 99243
RVUs × geographic indexes × conversion factor
Work1.80
1.80 RVUs× 1.000 GPCI
Practice expense1.46
1.46 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
3.3700
Conversion factor
$33.4009
Medicare rate
$112.56
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99243
99243 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 · 99243
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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99243 isn’t priced in this setting.
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
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