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.

CMS RVU26DEffective Oct 1, 2026One payment locality512.7K Medicare services in 2024

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.

$35.77Office (non-facility)
$27.80Hospital or facility
+3.0%vs the national office rate ($34.74)

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.

We’ll open G0316 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Hawaii, Guam, HI
  2. What G0316 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 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.

G0316 in Hawaii, Guam, HI vs other payment areas
  1. Hawaii, Guam, HI · this page$35.77
  2. Los Angeles, CA · California$37.33+$1.56
  3. Washington, DC area · District of Columbia$38.29+$2.52
  4. Miami, FL · Florida$37.81+$2.04
  5. Chicago, IL · Illinois$37.11+$1.34
  6. Manhattan, NY · New York$39.08+$3.31
  7. Alaska · Alaska$45.00+$9.23

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

Every other payment area

G0316 in every other Medicare payment locality
Payment localityOfficeFacility
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

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
G0316 office rate range by state
State / territoryOffice rate rangeLocalities
AK$45.001
AL$32.431
AR$32.141
AZ$34.101
CA$35.53–$41.8129
CO$35.431
CT$36.471
DC$38.291
DE$34.521
FL$35.02–$37.813
GA$33.69–$35.342
GU$35.771
HI$35.771
IA$32.651
ID$32.841
IL$34.57–$37.114
IN$32.951
KS$32.691
KY$33.191
LA$33.21–$34.222
MA$35.40–$37.852
MD$34.96–$38.293
ME$33.09–$34.012
MI$33.85–$35.442
MN$33.931
MO$32.94–$34.133
MS$32.541
MT$34.731
NC$33.281
ND$33.741
NE$32.721
NH$35.051
NJ$36.88–$38.162
NM$34.021
NV$34.471
NY$33.61–$39.875
OH$33.651
OK$33.011
OR$34.19–$36.042
PA$33.60–$35.952
PR$34.851
RI$35.361
SC$33.521
SD$33.631
TN$32.811
TX$33.48–$35.448
UT$33.811
VA$34.03–$38.292
VI$34.851
VT$33.791
WA$35.28–$38.332
WI$33.051
WV$33.791
WY$34.301

See G0316 in every payment locality

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

Office or facility?

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
Office calculation for G0316 in Hawaii, Guam, HI
ComponentRVULocality factorAdjusted
Physician work0.61× 1.0000.6100
Practice expense0.38× 1.1370.4321
Malpractice0.05× 0.5790.0290
Total RVUs1.0710
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

Open G0316 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician 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.

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

    $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.

  2. January 1, 2025

    RVU25A

    $32.53changed to$31.61

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $32.00changed to$32.53

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. 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
  5. January 1, 2023

    RVU23A

    No ratechanged to$32.83

    Held through RVU23B, RVU23C, RVU23D.

  6. 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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$35.77$27.80RVU26D
2026-07-01$35.77$27.80RVU26C
2026-04-01$35.77$27.80RVU26B
2026-01-01$35.77$27.80RVU26A
2025-10-01$31.61$30.12RVU25D
2025-07-01$31.61$30.12RVU25C
2025-04-01$31.61$30.12RVU25B
2025-01-01$31.61$30.12RVU25A
2024-10-01$32.53$30.61RVU24D
2024-07-01$32.53$30.61RVU24C
2024-04-01$32.53$30.61RVU24B
2024-03-09$32.53$30.61RVU24AR
2024-01-01$32.00$30.11RVU24A
2023-10-01$32.83$31.28RVU23D
2023-07-01$32.83$31.28RVU23C
2023-04-01$32.83$31.28RVU23B
2023-01-01$32.83$31.28RVU23A
2022-10-01Not in this releaseNot in this releaseRVU22D
2022-07-01Not in this releaseNot in this releaseRVU22C
2022-04-01Not in this releaseNot in this releaseRVU22B
2022-01-01Not in this releaseNot in this releaseRVU22A
2021-10-01Not in this releaseNot in this releaseRVU21D
2021-07-01Not in this releaseNot in this releaseRVU21C
2021-04-01Not in this releaseNot in this releaseRVU21B
2021-01-01Not in this releaseNot in this releaseRVU21A
2020-10-01Not in this releaseNot in this releaseRVU20D
2020-07-01Not in this releaseNot in this releaseRVU20C
2020-04-01Not in this releaseNot in this releaseRVU20B
2020-01-01Not in this releaseNot in this releaseRVU20A
2019-10-01Not in this releaseNot in this releaseRVU19D
2019-07-01Not in this releaseNot in this releaseRVU19C
2019-04-01Not in this releaseNot in this releaseRVU19B
2019-01-01Not in this releaseNot in this releaseRVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price G0316 for an earlier date of service

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

Browse all communities in Hawaii

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
RVUs for G0316PPRRVU2026_Oct_nonQPP.csv, line 15,193 (RVU26D)
Geographic factors for Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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