HCPCS code G0316: Prolonged E/M, inpatient or observation care2026 Medicare rate & RVUs in Hawaii, Guam, HI
Reports qualifying time beyond an eligible hospital inpatient or observation E/M service when the physician or qualified health professional provides extended care.
In Hawaii, Guam, HI, Medicare pays $35.77 for G0316 in the office and $27.80 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · G0316 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What G0316 covers
G0316 represents additional physician or qualified health professional time spent on hospital inpatient or observation evaluation and management beyond the time for an eligible primary service. It may accompany an initial hospital care service, a subsequent hospital care service, or same-day admission and discharge care. The work may include continued assessment, review of clinical information, treatment planning, and coordination related to the patient’s hospital care. It is used for care in hospital inpatient and observation settings, not for prolonged nursing facility or home E/M services.
Report G0316 only with an eligible primary service, such as 99223, 99233, or 99236; it is not a stand-alone service. Select the primary E/M code under the applicable visit rules, then report G0316 for documented qualifying time beyond that service’s time threshold, in the additional intervals required for the add-on. Documentation should support the total time on the date of service and the work performed. CMS treats G0316 as an add-on paid within the primary procedure’s global period.
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 Hawaii, Guam, HI compares for G0316
Across 109 of 109 payment localities, the office rate for G0316 runs from $32.14 in Arkansas to $45.00 in Alaska. Hawaii, Guam, HI pays $35.77. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Hawaii, Guam, HI · this page$35.77
- Los Angeles, CA · California$37.33+$1.56
- Washington, DC area · District of Columbia$38.29+$2.52
- Miami, FL · Florida$37.81+$2.04
- Chicago, IL · Illinois$37.11+$1.34
- Manhattan, NY · New York$39.08+$3.31
- Alaska · Alaska$45.00+$9.23
Other areas in Hawaii first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $32.43 | $26.29 |
| ArkansasArkansas | $32.14 | $26.11 |
| ArizonaArizona | $34.10 | $27.31 |
| Bakersfield, CACalifornia | $35.69 | $28.00 |
| Chico, CACalifornia | $35.53 | $27.84 |
| El Centro, CACalifornia | $35.54 | $27.85 |
| Fresno, CACalifornia | $35.53 | $27.84 |
| Hanford, CACalifornia | $35.53 | $27.84 |
| Madera, CACalifornia | $35.53 | $27.84 |
| Merced, CACalifornia | $35.53 | $27.84 |
| Modesto, CACalifornia | $35.53 | $27.84 |
| Napa, CACalifornia | $39.24 | $29.99 |
| Oxnard, CACalifornia | $36.99 | $28.70 |
| Redding, CACalifornia | $35.53 | $27.84 |
| Rest of CaliforniaCalifornia | $35.53 | $27.84 |
| Riverside, CACalifornia | $36.08 | $28.39 |
| Sacramento, CACalifornia | $36.76 | $28.61 |
| Salinas, CACalifornia | $36.61 | $28.48 |
| San Diego, CACalifornia | $37.07 | $28.68 |
| Marin County, CACalifornia | $40.97 | $31.08 |
| San Francisco, CACalifornia | $40.92 | $31.03 |
| San Benito County, CACalifornia | $41.81 | $31.70 |
| Santa Clara County, CACalifornia | $41.58 | $31.47 |
| San Luis Obispo, CACalifornia | $36.07 | $28.08 |
| Santa Cruz, CACalifornia | $37.12 | $28.60 |
| Santa Maria, CACalifornia | $36.64 | $28.46 |
| Santa Rosa, CACalifornia | $37.47 | $28.85 |
| Stockton, CACalifornia | $35.53 | $27.84 |
| Vallejo, CACalifornia | $39.15 | $29.91 |
| Visalia, CACalifornia | $35.53 | $27.84 |
| Yuba City, CACalifornia | $35.53 | $27.84 |
| ColoradoColorado | $35.43 | $27.96 |
| ConnecticutConnecticut | $36.47 | $28.92 |
| DelawareDelaware | $34.52 | $27.59 |
| Fort Lauderdale, FLFlorida | $36.25 | $29.15 |
| Rest of FloridaFlorida | $35.02 | $28.31 |
| Atlanta, GAGeorgia | $35.34 | $28.21 |
| Rest of GeorgiaGeorgia | $33.69 | $27.43 |
| IowaIowa | $32.65 | $26.23 |
| IdahoIdaho | $32.84 | $26.39 |
| East St. Louis, ILIllinois | $35.41 | $28.96 |
| Rest of IllinoisIllinois | $34.57 | $28.17 |
| Suburban Chicago, ILIllinois | $36.51 | $29.31 |
| IndianaIndiana | $32.95 | $26.45 |
| KansasKansas | $32.69 | $26.35 |
| KentuckyKentucky | $33.19 | $26.95 |
| New Orleans, LALouisiana | $34.22 | $27.61 |
| Rest of LouisianaLouisiana | $33.21 | $27.00 |
| Metropolitan Boston, MAMassachusetts | $37.85 | $29.48 |
| Rest of MassachusettsMassachusetts | $35.40 | $28.01 |
| Baltimore area, MDMaryland | $36.39 | $28.86 |
| Rest of MarylandMaryland | $34.96 | $27.86 |
| Rest of MaineMaine | $33.09 | $26.64 |
| Southern Maine, MEMaine | $34.01 | $27.06 |
| Detroit, MIMichigan | $35.44 | $28.67 |
| Rest of MichiganMichigan | $33.85 | $27.44 |
| MinnesotaMinnesota | $33.93 | $26.71 |
| Metropolitan Kansas City, MOMissouri | $33.92 | $27.34 |
| Metropolitan St. Louis, MOMissouri | $34.13 | $27.45 |
| Rest of MissouriMissouri | $32.94 | $26.90 |
| MississippiMississippi | $32.54 | $26.50 |
| MontanaMontana | $34.73 | $27.72 |
| North CarolinaNorth Carolina | $33.28 | $26.74 |
| North DakotaNorth Dakota | $33.74 | $26.73 |
| NebraskaNebraska | $32.72 | $26.25 |
| New HampshireNew Hampshire | $35.05 | $27.75 |
| Northern New JerseyNew Jersey | $38.16 | $30.03 |
| Rest of New JerseyNew Jersey | $36.88 | $29.22 |
| New MexicoNew Mexico | $34.02 | $27.59 |
| NevadaNevada | $34.47 | $27.45 |
| NYC suburbs and Long Island, NYNew York | $39.87 | $31.53 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $37.21 | $29.53 |
| Queens, NYNew York | $39.09 | $30.80 |
| Rest of New YorkNew York | $33.61 | $26.94 |
| OhioOhio | $33.65 | $27.24 |
| OklahomaOklahoma | $33.01 | $26.74 |
| Portland, OROregon | $36.04 | $28.25 |
| Rest of OregonOregon | $34.19 | $27.20 |
| Metropolitan Philadelphia, PAPennsylvania | $35.95 | $28.64 |
| Rest of PennsylvaniaPennsylvania | $33.60 | $27.17 |
| Puerto RicoPuerto Rico | $34.85 | $27.76 |
| Rhode IslandRhode Island | $35.36 | $28.12 |
| South CarolinaSouth Carolina | $33.52 | $27.04 |
| South DakotaSouth Dakota | $33.63 | $26.61 |
| TennesseeTennessee | $32.81 | $26.43 |
| Austin, TXTexas | $35.32 | $27.90 |
| Beaumont, TXTexas | $33.48 | $27.09 |
| Brazoria, TXTexas | $34.42 | $27.47 |
| Dallas, TXTexas | $34.63 | $27.65 |
| Fort Worth, TXTexas | $34.53 | $27.61 |
| Galveston, TXTexas | $34.52 | $27.56 |
| Houston, TXTexas | $35.44 | $28.47 |
| Rest of TexasTexas | $33.93 | $27.27 |
| UtahUtah | $33.81 | $27.21 |
| VirginiaVirginia | $34.03 | $27.14 |
| Virgin Islands, VIUnited States Virgin Islands | $34.85 | $27.76 |
| VermontVermont | $33.79 | $26.84 |
| Rest of WashingtonWashington | $35.28 | $27.89 |
| King County, WAWashington | $38.33 | $29.72 |
| WisconsinWisconsin | $33.05 | $26.33 |
| West VirginiaWest Virginia | $33.79 | $27.70 |
| WyomingWyoming | $34.30 | $27.29 |
G0316 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.
$32.14
$45.00
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $45.00 | 1 |
| AL | $32.43 | 1 |
| AR | $32.14 | 1 |
| AZ | $34.10 | 1 |
| CA | $35.53–$41.81 | 29 |
| CO | $35.43 | 1 |
| CT | $36.47 | 1 |
| DC | $38.29 | 1 |
| DE | $34.52 | 1 |
| FL | $35.02–$37.81 | 3 |
| GA | $33.69–$35.34 | 2 |
| GU | $35.77 | 1 |
| HI | $35.77 | 1 |
| IA | $32.65 | 1 |
| ID | $32.84 | 1 |
| IL | $34.57–$37.11 | 4 |
| IN | $32.95 | 1 |
| KS | $32.69 | 1 |
| KY | $33.19 | 1 |
| LA | $33.21–$34.22 | 2 |
| MA | $35.40–$37.85 | 2 |
| MD | $34.96–$38.29 | 3 |
| ME | $33.09–$34.01 | 2 |
| MI | $33.85–$35.44 | 2 |
| MN | $33.93 | 1 |
| MO | $32.94–$34.13 | 3 |
| MS | $32.54 | 1 |
| MT | $34.73 | 1 |
| NC | $33.28 | 1 |
| ND | $33.74 | 1 |
| NE | $32.72 | 1 |
| NH | $35.05 | 1 |
| NJ | $36.88–$38.16 | 2 |
| NM | $34.02 | 1 |
| NV | $34.47 | 1 |
| NY | $33.61–$39.87 | 5 |
| OH | $33.65 | 1 |
| OK | $33.01 | 1 |
| OR | $34.19–$36.04 | 2 |
| PA | $33.60–$35.95 | 2 |
| PR | $34.85 | 1 |
| RI | $35.36 | 1 |
| SC | $33.52 | 1 |
| SD | $33.63 | 1 |
| TN | $32.81 | 1 |
| TX | $33.48–$35.44 | 8 |
| UT | $33.81 | 1 |
| VA | $34.03–$38.29 | 2 |
| VI | $34.85 | 1 |
| VT | $33.79 | 1 |
| WA | $35.28–$38.33 | 2 |
| WI | $33.05 | 1 |
| WV | $33.79 | 1 |
| WY | $34.30 | 1 |
How the G0316 rate is calculated
Each of G0316’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 · G0316
RVUs × geographic indexes × conversion factor
Work0.61
0.61 RVUs× 1.000 GPCI
Practice expense0.38
0.38 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
1.0400
Conversion factor
$33.4009
Medicare rate
$34.74
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Hawaii, Guam, HI inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
15,193
- Code
- G0316
- Physician work
- 0.61
- Practice expense
- 0.38
- Malpractice
- 0.05
GPCI2026.csv
46
- Locality
- Hawaii, Guam, HI
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.61 | × 1.000 | 0.6100 |
| Practice expense | 0.38 | × 1.137 | 0.4321 |
| Malpractice | 0.05 | × 0.579 | 0.0290 |
| Total RVUs | 1.0710 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Hawaii, Guam, HI$35.77
Office: (0.61 × 1 + 0.38 × 1.137 + 0.05 × 0.579) × $33.4009 = $35.77
Facility: (0.61 × 1 + 0.17 × 1.137 + 0.05 × 0.579) × $33.4009 = $27.80
Payment rules and modifiers for G0316
The CMS indicators that decide how G0316 is paid alongside other services.
CMS payment indicators · G0316
Prolonged E/M, inpatient or observation care
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
How G0316 has changed in Hawaii, Guam, HI
G0316 · Office / nonfacility
$35.77
Effective 2026-10-01
The base rate is $4.16 higher than on 2025-10-01, moving from $31.61 to $35.77 (13.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$31.61changed to$35.77
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.30 changed to 0.38
- Malpractice RVU 0.04 changed to 0.05
- Practice expense GPCI 1.149 changed to 1.137
- Malpractice GPCI 0.561 changed to 0.579
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$32.53changed to$31.61
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$32.00changed to$32.53
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$32.83changed to$32.00
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.29 changed to 0.30
- Work GPCI 1.003 changed to 1.000
- Practice expense GPCI 1.146 changed to 1.149
- Malpractice GPCI 0.618 changed to 0.561
January 1, 2023
RVU23A
No ratechanged to$32.83
Held through RVU23B, RVU23C, RVU23D.
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, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $35.77 | $27.80 | RVU26D |
| 2026-07-01 | $35.77 | $27.80 | RVU26C |
| 2026-04-01 | $35.77 | $27.80 | RVU26B |
| 2026-01-01 | $35.77 | $27.80 | RVU26A |
| 2025-10-01 | $31.61 | $30.12 | RVU25D |
| 2025-07-01 | $31.61 | $30.12 | RVU25C |
| 2025-04-01 | $31.61 | $30.12 | RVU25B |
| 2025-01-01 | $31.61 | $30.12 | RVU25A |
| 2024-10-01 | $32.53 | $30.61 | RVU24D |
| 2024-07-01 | $32.53 | $30.61 | RVU24C |
| 2024-04-01 | $32.53 | $30.61 | RVU24B |
| 2024-03-09 | $32.53 | $30.61 | RVU24AR |
| 2024-01-01 | $32.00 | $30.11 | RVU24A |
| 2023-10-01 | $32.83 | $31.28 | RVU23D |
| 2023-07-01 | $32.83 | $31.28 | RVU23C |
| 2023-04-01 | $32.83 | $31.28 | RVU23B |
| 2023-01-01 | $32.83 | $31.28 | RVU23A |
| 2022-10-01 | Not in this release | Not in this release | RVU22D |
| 2022-07-01 | Not in this release | Not in this release | RVU22C |
| 2022-04-01 | Not in this release | Not in this release | RVU22B |
| 2022-01-01 | Not in this release | Not in this release | RVU22A |
| 2021-10-01 | Not in this release | Not in this release | RVU21D |
| 2021-07-01 | Not in this release | Not in this release | RVU21C |
| 2021-04-01 | Not in this release | Not in this release | RVU21B |
| 2021-01-01 | Not in this release | Not in this release | RVU21A |
| 2020-10-01 | Not in this release | Not in this release | RVU20D |
| 2020-07-01 | Not in this release | Not in this release | RVU20C |
| 2020-04-01 | Not in this release | Not in this release | RVU20B |
| 2020-01-01 | Not in this release | Not in this release | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Hawaii, Guam, HI rate applies
Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.
- Ahuimanu
- Aiea
- Ainaloa
- Anahola
- Black Sands
- Captain Cook
- Discovery Harbour
- East Honolulu
G0316 billing questions
Which primary E/M codes can be paired with G0316?
G0316 is reported with eligible hospital inpatient or observation care services, including 99223, 99233, and 99236. It cannot be submitted by itself.
When does the documented time support G0316?
The primary service’s time requirement must be met, with qualifying additional time beyond its threshold for each reported add-on interval. Document the total time and the work performed.
Can time for a separately billed service count toward G0316?
Do not count time spent on a separately reported service toward the prolonged E/M time. The documentation should make the time attributable to the E/M work clear.
Should G0316 be used for prolonged nursing facility care?
No. G0316 is for hospital inpatient or observation care; G0317 is the related prolonged-service code for nursing facility E/M.
How does CMS pay G0316?
CMS treats G0316 as an add-on code paid within the primary procedure’s global period. It must be billed with an eligible primary E/M 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
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