Which Of The Following Cpt Codes Have Assigned Relative Value

Which of the following CPT codes have assigned relative value is a question that arises frequently among medical billers, coders, and healthcare administrators who need to understand how services are reimbursed. The term relative value refers to the weight assigned to a Current Procedural Terminology (CPT) code that determines its payment amount under Medicare and many private payer fee schedules. In this article we will explore the mechanics behind relative value assignment, examine a selection of frequently used CPT codes that carry an assigned relative value, and provide practical guidance on how to verify and interpret these values for accurate billing.

Understanding Relative Value in CPT Coding

The Relative Value Scale (RVS) is the foundation of Medicare’s physician payment system and many other payer reimbursement models. Each CPT code is assigned three components:

1. Work RVU – reflects the physician’s effort, skill, and time required to perform the service.
2. Practice Expense RVU – accounts for overhead costs such as equipment, supplies, and office rent. 3. Malpractice RVU – captures the cost of professional liability insurance for the service.

These three RVUs are summed to produce a Total RVU, which is then multiplied by a Conversion Factor set annually by the Centers for Medicare & Medicaid Services (CMS). The resulting figure represents the base payment before any adjustments for geographic location, specialties, or volume discounts.

The official docs gloss over this. That's a mistake.

Why does this matter? When a CPT code does not have an assigned relative value, it typically means the service is considered non‑covered, investigational, or bundled into another code, and therefore cannot be billed separately for reimbursement. Conversely, codes with an assigned relative value are eligible for payment, subject to the rules of the payer.

How CMS Determines Which CPT Codes Receive an Assigned Relative Value

1. Legislative Mandate – Congress dictates which services are covered under the Medicare Physician Fee Schedule (MPFS).
2. CPT Editorial Panel Review – The American Medical Association (AMA) CPT Editorial Panel submits proposals for new, deleted, or revised codes.
3. RVU Assignment Committee – An expert panel evaluates the work, practice expense, and malpractice components and recommends RVU values. 4. Final Determination – CMS incorporates these recommendations into the MPFS, assigning a relative value to each eligible CPT code.

The outcome is a list of CPT codes that carry an assigned relative value, while codes outside this list are either non‑covered or bundled and therefore lack a standalone payment amount.

Common CPT Codes That Have Assigned Relative Value

Below is a curated list of frequently used CPT codes that do have an assigned relative value. The list is not exhaustive but illustrates the breadth of services that are reimbursable under the MPFS.

Evaluation and Management (E/M) Services

• 99201 – New patient, brief evaluation (0.25 Work RVU) - 99202 – New patient, low complexity (0.50 Work RVU)
• 99203 – New patient, moderate complexity (0.97 Work RVU) - 99204 – New patient, high complexity (1.89 Work RVU)
• 99211 – Established patient, minimal visit (0.25 Work RVU)
• 99212 – Established patient, low complexity (0.50 Work RVU)
• 99213 – Established patient, moderate complexity (0.97 Work RVU)
• 99214 – Established patient, high complexity (1.89 Work RVU)
• 99215 – Established patient, highest complexity (3.53 Work RVU)

Procedural Services- 93000 – Electrocardiography, routine ECG with at least 12 leads (0.58 Work RVU)

• 93010 – Holter monitoring, up to 24 hours (0.58 Work RVU)
• 93040 – Holter monitoring, 24‑hour recording (1.07 Work RVU)
• 99213 – Office or other outpatient visit for evaluation and management of an established patient (see above)
• 99221 – Subsequent hospital care, low complexity (0.97 Work RVU)
• 99222 – Subsequent hospital care, moderate complexity (1.95 Work RVU)
• 99223 – Subsequent hospital care, high complexity (2.96 Work RVU)

Diagnostic Imaging

• 71020 – Radiologic examination, chest, 1 view, frontal (0.30 Work RVU)
• 71045 – Radiologic examination, chest, 2 views, frontal and lateral (0.55 Work RVU)
• 71046 – Radiologic examination, chest, 3 views, frontal and lateral plus PA (0.70 Work RVU)
• 71047 – Radiologic examination, chest, 4 views, frontal, lateral, PA, and oblique (0.85 Work RVU) ### Laboratory Services
• 83036 – Hemoglobin A1c (glycosylated hemoglobin), quantitative (0.25 Work RVU)
• 83091 – Hemoglobin A1c, qualitative (0.25 Work RVU)
• 84443 – Prothrombin time (PT), quantitative (0.25 Work RVU)

Therapy and Rehabilitation

• 97001 – Application of a modality (e.g., hot or cold packs

Therapy and Rehabilitation (continued)

• 97110 – Therapeutic exercise (0.45 Work RVU)
• 97112 – Manual therapy (0.35 Work RVU)
• 97113 – Neuromuscular re-education (0.50 Work RVU)
• 97114 – Gait training (0.60 Work RVU)

Mental Health Services

• 90791 – Initial diagnostic assessment (1.25 Work RVU)
• 90834 – Group therapy session (0.40 Work RVU)

Pharmacotherapy

• 99213 – Office visit for medication management (0.97 Work RVU)
• 99401 – New patient initial evaluation for medication (1.50 Work RVU)

Conclusion