A reader asked me if I could explain what the most common hospitalist evaluation and management (E/M) codes were and provide a list of their RVU values. Here is the question:
I recently found your website and love it. I am finishing up my last few months of residency and starting as a Hospitalist July 1. I was just curious if you could send a revised list of the most common RVUs used on a day to day basis. Have they changed since Nov 2010? I am having to learn all inpatient billing/coding/RVU on my own and I've learned a ton from your site. I still have 4 months to learn as much as I can before actually start handing in my charges. I was also wondering if you could email or send me a link to your card thing you carry around that lets you add up point for decision making. Thanks for creating your site.
- Read How Doctors Get Paid
- Read What Is An RVU
- Read RVU Explained
- Hospitalist compensation/wRVU. Understand what you're worth.
- Read all of 'em at my lectures on Medical billing and coding
- hospitalist salary vs productivity
- Explain CPT® and ICD Codes. What is the Difference?
Now for why you're here. Here is an updated list of the most common evaluation and management CPT® codes you will use and the RVU value (work and total) for each code. These are updated for 2011. There are some changes for 2010 vs 2011, but the changes mostly have to do with an increase in the practice expense component of the RVU total.
Remember, your progress notes will be filled with diagnoses (ICD codes). You link the ICD codes (a maximum of four ICD codes will be submitted for billing) to your E/M CPT® code (as below) . The CPT® codes are the E/M codes. Each E/M code is worth a specific number of total relative value units (RVUs). The total RVU for each E/M code (CPT® code) is a sum of the workRVU + malpractice RVU + practice expense RVU.
There are published hospitalist benchmarks with regards to RVU embedded in the 2010 SHM/MGMA Hospitalist Salary Compensation Survey which can give you a great sense of what you are worth as can the 2011 Hospitalist Salary Survey by Today's Hospitalist.
When you are applying for a job and your compensation is dependent on production, most programs will use RVUs as their marker of production. You want an apples to apples comparison between programs. Make sure you understand what you're reading in your contract. You want to know if your productivity benchmarks are in total RVUs or work RVUs, because there is a huge difference in these values.
When you are applying for a job and your compensation is dependent on production, most programs will use RVUs as their marker of production. You want an apples to apples comparison between programs. Make sure you understand what you're reading in your contract. You want to know if your productivity benchmarks are in total RVUs or work RVUs, because there is a huge difference in these values.
With that said, here are your 2011 values for the most commonly used E/M hospitalist CPT® codes and their RVU values, both totalRVU (tRVU) and workRVU (wRVU).
| CPT® description 2011 TABLE | CPT® | (wRVU) | (tRVU) |
| low level in-patient admit | 99221 | 1.92 | 2.86 |
| mid level in-patient admit | 99222 | 2.61 | 3.89 |
| high level in-patient admit | 99223 | 3.86 | 5.71 |
| low level observation admit | 99218 | 1.28 | 1.90 |
| mid level observation admit | 99219 | 2.14 | 3.17 |
| high level observation admit | 99220 | 2.99 | 4.43 |
| low level admit/dc same date | 99234 | 2.56 | 3.88 |
| mid level admit/dc same date | 99235 | 3.41 | 5.07 |
| high level admit/dc same date | 99236 | 4.26 | 6.30 |
| low level in-patient consult | 99253 | 2.27 | 3.26 |
| mid level in-patient consult | 99254 | 3.29 | 4.70 |
| high level in-patient consult | 99255 | 4.0 | 5.68 |
| low level in-patient follow-up | 99231 | 0.76 | 1.13 |
| mid level in-patient follow-up | 99232 | 1.39 | 2.05 |
| high level in-patient follow-up | 99233 | 2.0 | 2.94 |
| low level observation follow-up | 99224 | 0.54 | 0.82 |
| mid level observation follow-up | 99225 | 0.96 | 1.45 |
| high level observation follow-up | 99226 | 1.44 | 2.17 |
| <30 minutes in-patient discharge | 99238 | 1.28 | 2.04 |
| >30 minutes in-patient discharge | 99239 | 1.9 | 2.99 |
| observation discharge | 99217 | 1.28 | 2.04 |
| critical care initial | 99291 | 4.5 | 6.4 |
| critical care add on | 99292 | 2.25 | 3.21 |
| prolonged service initial in-patient | 99356 | 1.71 | 2.57 |
| prolonged service add on in-patient | 99357 | 1.71 | 2.58 |
| central line | 36556 | 2.5 | 3.61 |
| paracentesis | 49080 | 1.35 | 2.05 |
| lumbar puncture | 62270 | 1.37 | 2.32 |
| thoracentesis | 32421 | 1.54 | 2.28 |
| CPR/Resuscitation | 92950 | 3.79 | 5.14 |
| smoking cessation counseling 3-10 min | 99406 | 0.24 | 0.35 |
| smoking cessation counseling > 10 min | 99407 | 0.5 | 0.73 |
| CPT® description 2012 TABLE | CPT® | (wRVU) | (tRVU) |
| low level in-patient admit | 99221 | 1.92 | 2.92 |
| mid level in-patient admit | 99222 | 2.61 | 3.96 |
| high level in-patient admit | 99223 | 3.86 | 5. |
| low level observation admit | 99218 | 1.92 | 2.85 |
| mid level observation admit | 99219 | 2.60 | 3.90 |
| high level observation admit | 99220 | 3.56 | 5.32 |
| low level admit/dc same date | 99234 | 2.56 | 3.88 |
| mid level admit/dc same date | 99235 | 3.24 | 4.86 |
| high level admit/dc same date | 99236 | 4.20 | 6.27 |
| low level in-patient consult | 99253 | 2.27 | 3.26 |
| mid level in-patient consult | 99254 | 3.29 | 4.70 |
| high level in-patient consult | 99255 | 4.0 | 5.68 |
| low level in-patient follow-up | 99231 | 0.76 | 1.13 |
| mid level in-patient follow-up | 99232 | 1.39 | 2.07 |
| high level in-patient follow-up | 99233 | 2.0 | 2.97 |
| low level observation follow-up | 99224 | 0.76 | 1.14 |
| mid level observation follow-up | 99225 | 1.39 | 2.06 |
| high level observation follow-up | 99226 | 2.0 | 2.96 |
| <30 minutes in-patient discharge | 99238 | 1.28 | 2.07 |
| >30 minutes in-patient discharge | 99239 | 1.9 | 3.07 |
| observation discharge | 99217 | 1.28 | 2.08 |
| critical care initial | 99291 | 4.5 | 6.42 |
| critical care add on | 99292 | 2.25 | 3.22 |
| prolonged service initial in-patient | 99356 | 1.71 | 2.64 |
| prolonged service add on in-patient | 99357 | 1.71 | 2.61 |
| central line | 36556 | 2.5 | 3.61 |
| paracentesis | 49082 | 1.24 | 2.05 |
| lumbar puncture | 62270 | 1.37 | 2.29 |
| thoracentesis | 32421 | 1.54 | 2.22 |
| CPR/Resuscitation | 92950 | 4.0 | 5.39 |
| smoking cessation counseling 3-10 min | 99406 | 0.24 | 0.35 |
| smoking cessation counseling > 10 min | 99407 | 0.5 | 0.74 |
LINK TO E/M POCKET REFERENCE CARD POST
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Successful software implementation starts with choosing the right system. This checklist contains over 50 of the most important features to look for when evaluating:
- electronic medical records
- medical billing software
- scheduling software
- technology, security and certifications
Other useful information is available at my EHR Resource Center. 
