CPT code 99310: Nursing facility visit, subsequent visit, high MDM2026 Medicare rate & RVUs in Vallejo, CA

Follow-up nursing facility or skilled nursing facility visit for a resident whose care requires high-complexity medical decision making or at least 45 minutes of practitioner time.

CMS RVU26DEffective Oct 1, 2026One payment locality2.2M Medicare services in 2024

In Vallejo, CA, Medicare pays $185.40 for 99310 in the office and $155.02 when it’s performed in a hospital or facility.

$185.40Office (non-facility)
$155.02Hospital or facility
+13.5%vs the national office rate ($163.33)

Check a contract rate as a % of Medicare · 99310 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 99310 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vallejo, CA
  2. What 99310 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 99310 covers

This is the highest level in the subsequent nursing facility E/M series. It covers a follow-up visit to a skilled nursing facility or long-term nursing facility resident after the initial evaluation. A practitioner might assess suspected sepsis, new respiratory failure, or a severe heart failure or COPD exacerbation and decide whether hospital transfer or a major change in treatment is needed. Attending physicians, geriatricians, nurse practitioners, and physician assistants commonly provide these visits during facility rounds.

Select 99310 when medical decision making is high or the reporting practitioner's qualifying time on the date of service reaches 45 minutes. High MDM requires two of three elements—problems, data, and management risk—at the high level; a hospitalization decision alone does not establish the overall level. Time may include examining the resident, reviewing records, coordinating with facility staff, and documenting, but excludes staff time and work counted toward another reported service. Document the supporting MDM elements or total qualifying time. If the visit is selected by time and Medicare's prolonged-service threshold is met, G0317 may be reported for eligible additional time.

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 Vallejo, CA compares for 99310

Across 109 of 109 payment localities, the office rate for 99310 runs from $151.07 in Arkansas to $211.02 in Alaska. Vallejo, CA pays $185.40. The RVUs are the same everywhere; the geographic indexes change the dollars.

99310 in Vallejo, CA vs other payment areas
  1. Vallejo, CA · this page$185.40
  2. Bakersfield, CA · California$168.39−$17.01
  3. Chico, CA · California$167.69−$17.71
  4. El Centro, CA · California$167.73−$17.67
  5. Fresno, CA · California$167.69−$17.71
  6. Hanford, CA · California$167.69−$17.71
  7. Los Angeles, CA · California$176.30−$9.10

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

Every other payment area

99310 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$167.69$142.43
Merced, CACalifornia$167.69$142.43
Modesto, CACalifornia$167.69$142.43
Napa, CACalifornia$185.74$155.36
Oxnard, CACalifornia$174.73$147.49
Redding, CACalifornia$167.69$142.43
Rest of CaliforniaCalifornia$167.69$142.43
Riverside, CACalifornia$170.01$144.75

99310 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.

$151.07

$211.02

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

View every state and territory as a table
99310 office rate range by state
State / territoryOffice rate rangeLocalities
AK$211.021
AL$152.441
AR$151.071
AZ$160.371
CA$167.69–$198.1229
CO$166.941
CT$171.511
DC$180.351
DE$162.341
FL$164.10–$176.633
GA$157.90–$166.032
GU$168.981
HI$168.981
IA$153.761
ID$154.611
IL$161.82–$173.384
IN$155.141
KS$153.821
KY$155.761
LA$155.81–$160.582
MA$166.73–$178.582
MD$164.44–$180.353
ME$155.66–$160.182
MI$158.77–$165.942
MN$160.211
MO$154.48–$160.333
MS$152.771
MT$163.321
NC$156.591
ND$159.161
NE$154.131
NH$165.031
NJ$173.53–$179.752
NM$159.531
NV$162.221
NY$158.11–$187.205
OH$157.921
OK$155.051
OR$161.00–$170.002
PA$157.80–$168.942
PR$163.921
RI$166.421
SC$157.511
SD$158.671
TN$154.371
TX$157.18–$166.368
UT$158.851
VA$160.20–$180.352
VI$163.921
VT$159.241
WA$166.20–$180.982
WI$155.841
WV$158.131
WY$161.511

See 99310 in every payment locality

How the 99310 rate is calculated

Each of 99310’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 · 99310

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.80

2.80 RVUs× 1.000 GPCI

Practice expense1.88

1.88 RVUs× 1.000 GPCI

Malpractice0.21

0.21 RVUs× 1.000 GPCI

Adjusted RVUs

4.8900

Conversion factor

$33.4009

Medicare rate

$163.33

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

The exact Vallejo, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,051

Code
99310
Physician work
2.80
Practice expense
1.88
Malpractice
0.21

GPCI2026.csv

33

Locality
Vallejo, CA
Physician work
1.063
Practice expense
1.318
Malpractice
0.459
Office calculation for 99310 in Vallejo, CA
ComponentRVULocality factorAdjusted
Physician work2.80× 1.0632.9764
Practice expense1.88× 1.3182.4778
Malpractice0.21× 0.4590.0964
Total RVUs5.5506
Conversion factor× 33.4009

Office rate, Vallejo, CA$185.40

Office: (2.8 × 1.063 + 1.88 × 1.318 + 0.21 × 0.459) × $33.4009 = $185.40

Facility: (2.8 × 1.063 + 1.19 × 1.318 + 0.21 × 0.459) × $33.4009 = $155.02

Open 99310 in the RVU calculator

Payment rules and modifiers for 99310

99310 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 · 99310

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$163.33

Non-facility (office)
$163.33
Facility
$140.28

Higher because the practice carries its own overhead.

How 99310 has changed in Vallejo, CA

99310 · Office / nonfacility

$185.40

Effective 2026-10-01

The base rate is $19.16 higher than on 2025-10-01, moving from $166.24 to $185.40 (11.5%).

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

    $166.24changed to$185.40

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.59 changed to 1.88
    • Malpractice RVU 0.20 changed to 0.21
    • Work GPCI 1.058 changed to 1.063
    • Practice expense GPCI 1.310 changed to 1.318
    • Malpractice GPCI 0.470 changed to 0.459

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $170.64changed to$166.24

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.58 changed to 1.59

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $167.85changed to$170.64

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $168.87changed to$167.85

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.54 changed to 1.58
    • Malpractice RVU 0.19 changed to 0.20
    • Work GPCI 1.051 changed to 1.058
    • Practice expense GPCI 1.265 changed to 1.310
    • Malpractice GPCI 0.487 changed to 0.470
  5. January 1, 2023

    RVU23A

    $145.19changed to$168.87

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 2.35 changed to 2.80
    • Practice expense RVU 1.37 changed to 1.54
    • Malpractice RVU 0.14 changed to 0.19
    • Work GPCI 1.044 changed to 1.051
    • Practice expense GPCI 1.220 changed to 1.265
    • Malpractice GPCI 0.504 changed to 0.487

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $146.56changed to$145.19

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.15 changed to 0.14

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $149.82changed to$146.56

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.31 changed to 1.37
    • Malpractice RVU 0.13 changed to 0.15
    • Work GPCI 1.049 changed to 1.044
    • Practice expense GPCI 1.238 changed to 1.220
    • Malpractice GPCI 0.496 changed to 0.504

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $151.29changed to$149.82

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.16 changed to 0.13
    • Work GPCI 1.055 changed to 1.049
    • Practice expense GPCI 1.256 changed to 1.238
    • Malpractice GPCI 0.458 changed to 0.496

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $152.48changed to$151.29

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.34 changed to 1.31

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $152.55changed to$152.48

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.33 changed to 1.34
    • Work GPCI 1.057 changed to 1.055
    • Practice expense GPCI 1.271 changed to 1.256
    • Malpractice GPCI 0.477 changed to 0.458

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$152.55

    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$185.40$155.02RVU26D
2026-07-01$185.40$155.02RVU26C
2026-04-01$185.40$155.02RVU26B
2026-01-01$185.40$155.02RVU26A
2025-10-01$166.24$166.24RVU25D
2025-07-01$166.24$166.24RVU25C
2025-04-01$166.24$166.24RVU25B
2025-01-01$166.24$166.24RVU25A
2024-10-01$170.64$170.64RVU24D
2024-07-01$170.64$170.64RVU24C
2024-04-01$170.64$170.64RVU24B
2024-03-09$170.64$170.64RVU24AR
2024-01-01$167.85$167.85RVU24A
2023-10-01$168.87$168.87RVU23D
2023-07-01$168.87$168.87RVU23C
2023-04-01$168.87$168.87RVU23B
2023-01-01$168.87$168.87RVU23A
2022-10-01$145.19$145.19RVU22D
2022-07-01$145.19$145.19RVU22C
2022-04-01$145.19$145.19RVU22B
2022-01-01$145.19$145.19RVU22A
2021-10-01$146.56$146.56RVU21D
2021-07-01$146.56$146.56RVU21C
2021-04-01$146.56$146.56RVU21B
2021-01-01$146.56$146.56RVU21A
2020-10-01$149.82$149.82RVU20D
2020-07-01$149.82$149.82RVU20C
2020-04-01$149.82$149.82RVU20B
2020-01-01$149.82$149.82RVU20A
2019-10-01$151.29$151.29RVU19D
2019-07-01$151.29$151.29RVU19C
2019-04-01$151.29$151.29RVU19B
2019-01-01$151.29$151.29RVU19A
2018-10-01$152.48$152.48RVU18D
2018-07-01$152.48$152.48RVU18C
2018-04-01$152.48$152.48RVU18B
2018-01-01$152.48$152.48RVU18AR1
2017-10-01$152.55$152.55RVU17D
2017-07-01$152.55$152.55RVU17C
2017-04-01$152.55$152.55RVU17B
2017-01-01$152.55$152.55RVU17A
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 99310 for an earlier date of service

Where the Vallejo, CA rate applies

Vallejo, CA is a Medicare payment area, not a city. Our Census mapping connects it to 11 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Vallejo
  • Allendale
  • Benicia
  • Dixon
  • Elmira
  • Fairfield
  • Green Valley
  • Hartley

Browse all communities in California

99310 billing questions

How do I decide between 99309 and 99310?

Use 99310 for high MDM or at least 45 minutes of qualifying time. Use 99309 for moderate MDM or at least 30 minutes when 99310's criteria are not met; a hospitalization decision can support high management risk but does not, by itself, establish high MDM.

Can 99310 be reported for a resident's first visit by our group?

Choose the code based on the service performed, not simply whether the resident is new to the group. Initial nursing facility codes 99304-99306 describe an initial evaluation; 99310 describes subsequent care.

What counts toward the 45 minutes?

Count the reporting practitioner's qualifying work on the date of service, such as examining the resident, reviewing records, coordinating care, ordering, and documenting. Exclude facility staff time and time spent on separately reported services.

How is prolonged time billed for Medicare with 99310?

When 99310 is selected by time and Medicare's threshold for prolonged nursing facility care is met, report G0317 for eligible additional 15-minute increments rather than CPT 99418. Document the total qualifying time.

Which place of service is used?

Use POS 31 for a skilled nursing facility stay and POS 32 for a nursing facility. Visits to assisted living residents fall under home or residence visit codes instead.

Can I bill 99310 and a discharge code for the same service?

No. When the service is nursing facility discharge management, report 99315 or 99316 according to the time spent on that service instead of 99310.

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 99310PPRRVU2026_Oct_nonQPP.csv, line 13,051 (RVU26D)
Geographic factors for Vallejo, CAGPCI2026.csv, line 33 (RVU26D)

Open CMS sourceHow we calculate rates

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