CPT code 99304: Nursing facility care, initial, straightforward or low complexity2026 Medicare rate & RVUs in El Centro, CA

Report this initial nursing facility evaluation when the documented medical decision making is straightforward or low complexity, or the service meets the 25-minute time threshold.

CMS RVU26DEffective Oct 1, 2026One payment locality342.1K Medicare services in 2024

In El Centro, CA, Medicare pays $83.33 for 99304 in the office and $72.35 when it’s performed in a hospital or facility.

$83.33Office (non-facility)
$72.35Hospital or facility
+2.7%vs the national office rate ($81.16)

Check a contract rate as a % of Medicare · 99304 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 99304 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in El Centro, CA
  2. What 99304 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 99304 covers

Code 99304 describes an initial evaluation and management service for a patient in a nursing facility, such as a skilled nursing facility or nursing home. A physician or other qualified health care professional assesses the patient’s condition and needs in that setting and establishes or updates the care plan. The patient may be new or established to the practitioner; the relevant distinction is that the service is initial nursing facility care, not a later follow-up visit.

Select this level when medical decision making is straightforward or low complexity, or when the practitioner’s total time on the date of service meets or exceeds 25 minutes. Document the medically appropriate history and examination, the problems addressed, the data reviewed or analyzed, and the management decisions; when selecting by time, document the qualifying time. CMS assigns work, practice-expense, and malpractice RVUs, with separate practice-expense values for office and facility settings.

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 El Centro, CA compares for 99304

Across 109 of 109 payment localities, the office rate for 99304 runs from $75.75 in Arkansas to $106.69 in Alaska. El Centro, CA pays $83.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

99304 in El Centro, CA vs other payment areas
  1. El Centro, CA · this page$83.33
  2. Bakersfield, CA · California$83.63+$0.30
  3. Chico, CA · California$83.31−$0.02
  4. Fresno, CA · California$83.31−$0.02
  5. Hanford, CA · California$83.31−$0.02
  6. Los Angeles, CA · California$87.34+$4.01
  7. Madera, CA · California$83.31−$0.02

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

Every other payment area

99304 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia$83.31$72.33
Modesto, CACalifornia$83.31$72.33
Napa, CACalifornia$91.76$78.56
Oxnard, CACalifornia$86.54$74.70
Redding, CACalifornia$83.31$72.33
Rest of CaliforniaCalifornia$83.31$72.33
Riverside, CACalifornia$84.32$73.34
Sacramento, CACalifornia$86.15$74.49

99304 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.

$75.75

$106.69

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

View every state and territory as a table
99304 office rate range by state
State / territoryOffice rate rangeLocalities
AK$106.691
AL$76.351
AR$75.751
AZ$79.861
CA$83.31–$97.6829
CO$82.901
CT$84.961
DC$89.201
DE$80.771
FL$81.44–$86.913
GA$78.71–$82.372
GU$83.741
HI$83.741
IA$76.971
ID$77.341
IL$80.42–$85.554
IN$77.571
KS$76.981
KY$77.791
LA$77.81–$79.922
MA$82.84–$88.332
MD$81.76–$89.203
ME$77.78–$79.802
MI$79.11–$82.242
MN$79.861
MO$77.21–$79.823
MS$76.481
MT$81.161
NC$78.201
ND$79.381
NE$77.131
NH$81.941
NJ$86.04–$89.012
NM$79.441
NV$80.691
NY$78.87–$92.255
OH$78.751
OK$77.491
OR$80.16–$84.312
PA$78.70–$83.802
PR$81.431
RI$82.721
SC$78.581
SD$79.171
TN$77.221
TX$78.43–$82.558
UT$79.171
VA$79.80–$89.202
VI$81.431
VT$79.401
WA$82.58–$89.492
WI$77.911
WV$78.781
WY$80.381

See 99304 in every payment locality

How the 99304 rate is calculated

Each of 99304’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 · 99304

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.50

1.50 RVUs× 1.000 GPCI

Practice expense0.84

0.84 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

2.4300

Conversion factor

$33.4009

Medicare rate

$81.16

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

The exact El Centro, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,045

Code
99304
Physician work
1.50
Practice expense
0.84
Malpractice
0.09

GPCI2026.csv

10

Locality
El Centro, CA
Physician work
1.017
Practice expense
1.096
Malpractice
0.541
Office calculation for 99304 in El Centro, CA
ComponentRVULocality factorAdjusted
Physician work1.50× 1.0171.5255
Practice expense0.84× 1.0960.9206
Malpractice0.09× 0.5410.0487
Total RVUs2.4948
Conversion factor× 33.4009

Office rate, El Centro, CA$83.33

Office: (1.5 × 1.017 + 0.84 × 1.096 + 0.09 × 0.541) × $33.4009 = $83.33

Facility: (1.5 × 1.017 + 0.54 × 1.096 + 0.09 × 0.541) × $33.4009 = $72.35

Open 99304 in the RVU calculator

Payment rules and modifiers for 99304

99304 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 · 99304

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$81.16

Non-facility (office)
$81.16
Facility
$71.14

Higher because the practice carries its own overhead.

How 99304 has changed in El Centro, CA

99304 · Office / nonfacility

$83.33

Effective 2026-10-01

The base rate is $4.34 higher than on 2025-10-01, moving from $78.99 to $83.33 (5.5%).

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

    $78.99changed to$83.33

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.78 changed to 0.84
    • Malpractice RVU 0.12 changed to 0.09
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.570 changed to 0.541

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $81.10changed to$78.99

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.11 changed to 0.12

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $79.77changed to$81.10

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $82.27changed to$79.77

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.77 changed to 0.78
    • Work GPCI 1.021 changed to 1.014
    • Practice expense GPCI 1.079 changed to 1.093
    • Malpractice GPCI 0.595 changed to 0.570
  5. January 1, 2023

    RVU23A

    $90.87changed to$82.27

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 1.64 changed to 1.50
    • Practice expense RVU 0.82 changed to 0.77
    • Work GPCI 1.027 changed to 1.021
    • Practice expense GPCI 1.065 changed to 1.079
    • Malpractice GPCI 0.620 changed to 0.595

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $91.61changed to$90.87

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice GPCI 0.616 changed to 0.620

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $93.91changed to$91.61

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.80 changed to 0.82
    • Work GPCI 1.024 changed to 1.027
    • Practice expense GPCI 1.070 changed to 1.065
    • Malpractice GPCI 0.606 changed to 0.616

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $92.94changed to$93.91

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.78 changed to 0.80
    • Malpractice RVU 0.12 changed to 0.11
    • Work GPCI 1.020 changed to 1.024
    • Practice expense GPCI 1.074 changed to 1.070
    • Malpractice GPCI 0.570 changed to 0.606

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $94.56changed to$92.94

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.83 changed to 0.78
    • Malpractice RVU 0.11 changed to 0.12
    • Malpractice GPCI 0.567 changed to 0.570

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $94.82changed to$94.56

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.079 changed to 1.074
    • Malpractice GPCI 0.610 changed to 0.567

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$94.82

    Held through RVU17B, RVU17C, RVU17D.

  12. 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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$83.33$72.35RVU26D
2026-07-01$83.33$72.35RVU26C
2026-04-01$83.33$72.35RVU26B
2026-01-01$83.33$72.35RVU26A
2025-10-01$78.99$78.99RVU25D
2025-07-01$78.99$78.99RVU25C
2025-04-01$78.99$78.99RVU25B
2025-01-01$78.99$78.99RVU25A
2024-10-01$81.10$81.10RVU24D
2024-07-01$81.10$81.10RVU24C
2024-04-01$81.10$81.10RVU24B
2024-03-09$81.10$81.10RVU24AR
2024-01-01$79.77$79.77RVU24A
2023-10-01$82.27$82.27RVU23D
2023-07-01$82.27$82.27RVU23C
2023-04-01$82.27$82.27RVU23B
2023-01-01$82.27$82.27RVU23A
2022-10-01$90.87$90.87RVU22D
2022-07-01$90.87$90.87RVU22C
2022-04-01$90.87$90.87RVU22B
2022-01-01$90.87$90.87RVU22A
2021-10-01$91.61$91.61RVU21D
2021-07-01$91.61$91.61RVU21C
2021-04-01$91.61$91.61RVU21B
2021-01-01$91.61$91.61RVU21A
2020-10-01$93.91$93.91RVU20D
2020-07-01$93.91$93.91RVU20C
2020-04-01$93.91$93.91RVU20B
2020-01-01$93.91$93.91RVU20A
2019-10-01$92.94$92.94RVU19D
2019-07-01$92.94$92.94RVU19C
2019-04-01$92.94$92.94RVU19B
2019-01-01$92.94$92.94RVU19A
2018-10-01$94.56$94.56RVU18D
2018-07-01$94.56$94.56RVU18C
2018-04-01$94.56$94.56RVU18B
2018-01-01$94.56$94.56RVU18AR1
2017-10-01$94.82$94.82RVU17D
2017-07-01$94.82$94.82RVU17C
2017-04-01$94.82$94.82RVU17B
2017-01-01$94.82$94.82RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 99304 for an earlier date of service

Where the El Centro, CA rate applies

El Centro, CA is a Medicare payment area, not a city. Our Census mapping connects it to 18 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • El Centro
  • Bombay Beach
  • Brawley
  • Calexico
  • Calipatria
  • Desert Shores
  • El Centro Naval Air Facility
  • Heber

Browse all communities in California

99304 billing questions

When should 99304 be chosen over 99305?

Use 99304 for an initial nursing facility service when medical decision making is straightforward or low complexity, or when selecting by time at the 25-minute threshold. Use 99305 when the documented medical decision making is moderate complexity or the applicable time threshold is met.

Does the patient have to be new to the practitioner?

No. The code is for initial nursing facility care and is not determined by whether the patient has previously seen that practitioner.

Can the level be selected by time?

Yes. The practitioner’s total time on the date of service must meet or exceed 25 minutes. Document the qualifying time and the work performed.

How does 99304 differ from a subsequent nursing facility visit?

99304 represents initial nursing facility care. For a later follow-up service in the facility, select the applicable subsequent nursing facility care level, such as 99307 or 99308.

What documentation supports 99304?

Document the clinical issues evaluated, the medically appropriate history and examination, and the reasoning behind the straightforward or low-complexity decisions. If selecting by time, document the total qualifying time on the date of service.

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 99304PPRRVU2026_Oct_nonQPP.csv, line 13,045 (RVU26D)
Geographic factors for El Centro, CAGPCI2026.csv, line 10 (RVU26D)

Open CMS sourceHow we calculate rates

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