CPT 99483
Global XXX ActiveAssmt & care pln pt cog imp
CPT 99483 Billing & Documentation Guide
CPT code 99483 (Assmt & care pln pt cog imp) is classified under E/M with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.84, a non-facility practice expense RVU of 4.66, and a malpractice RVU of 0.27, a total non-facility RVU of 8.77 and facility RVU of 5.08. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $301.04, though rates vary from $266.61 to $371.65 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 99483, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 99483 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 99483 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 99483
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.84 | 3.84 |
| Practice Expense RVU | 4.66 | 0.97 |
| Malpractice RVU | 0.27 | 0.27 |
| Total RVU | 8.77 | 5.08 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 99483
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $321.92 | $176.08 | $305.86 - $371.65 | 29 |
| Florida | $301.98 | $178.32 | $290.61 - $313.1 | 3 |
| Georgia | $287.73 | $170.15 | $277.85 - $297.61 | 2 |
| Illinois | $296.34 | $177.25 | $284.46 - $306.28 | 4 |
| Michigan | $287.11 | $171.38 | $280.55 - $293.66 | 2 |
| North Carolina | $279.24 | $164.25 | $279.24 - $279.24 | 1 |
| New York | $320.24 | $182.75 | $282.47 - $338.28 | 5 |
| Ohio | $279.46 | $166.93 | $279.46 - $279.46 | 1 |
| Pennsylvania | $291.52 | $170.79 | $279.67 - $303.36 | 2 |
| Texas | $290.58 | $169.24 | $278.28 - $301.18 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 99483
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 99483 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0359T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0360T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0361T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0362T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0362T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0363T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0364T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0365T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0366T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0367T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 99483
What does CPT code 99483 mean? +
CPT code 99483 represents: Assmt & care pln pt cog imp. It's in the E/M category with a global period of XXX.
What is the Medicare reimbursement for CPT 99483? +
The 2026 Medicare national average non-facility payment for CPT 99483 is $301.04. Rates range from $266.61 to $371.65 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 99483? +
E/M codes commonly use modifier 25 (significant separately identifiable E/M on same day as a procedure), 57 (decision for major surgery), 24 (unrelated E/M during global period), 95 (synchronous audio+video telehealth), 93 (audio-only telehealth), and AI (principal physician of record on admission). Surgical modifiers like 50, 51, 59 do not apply to E/M.
What bundling edits apply to CPT 99483? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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