CPT code 99345: Home visit, new patient, high complexity2026 Medicare rate & RVUs in Barrington, Illinois

CPT 99345: $219.39–$222.17 office across 2 localities in Barrington, IL in 2026 Medicare. Compare each area.

CMS RVU26DEffective Oct 1, 20262 payment localities

Medicare pays $219.39–$222.17 for 99345 in the office in Barrington, Illinois, from Suburban Chicago, IL to Chicago, IL. Which amount applies depends on the service address.

$219.39–$222.17Office (non-facility)
—Hospital or facility

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 99345 for the payment locality that covers the ZIP.

On this page 6 sections
  1. Rate in Barrington, Illinois
  2. By payment locality
  3. City and payment areas
  4. How it’s calculated
  5. Payment rules
  6. Sources

Where 99345 pays more and less in Barrington, Illinois

Barrington, Illinois maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.

99345 office and facility rates by payment locality
Payment localityOfficeFacility
Chicago, IL$222.17Unavailable
Suburban Chicago, IL$219.39Unavailable

How payment areas work in Barrington

City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.

  • Chicago · Cook County
  • Suburban Chicago · Lake County

City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions

How the 99345 rate is calculated

Each of 99345’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 · 99345

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.88

3.88 RVUs× 1.000 GPCI

Practice expense2.16

2.16 RVUs× 1.000 GPCI

Malpractice0.25

0.25 RVUs× 1.000 GPCI

Adjusted RVUs

6.2900

Conversion factor

$33.4009

Medicare rate

$210.09

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

Payment rules and modifiers for 99345

99345 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 · 99345

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$210.09

Higher because the practice carries its own overhead.

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 99345PPRRVU2026_Oct_nonQPP.csv, line 13,057 (RVU26D)

Open CMS sourceHow we calculate rates

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