HCPCS code G0316: Prolonged E/M, inpatient or observation care2026 Medicare rate & RVUs in New Mexico

In New Mexico, Medicare pays $34.02 for G0316 in the office and $27.59 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.

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 New Mexico 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. New Mexico pays $34.02. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

G0316 rates by state

Office rate range in each state. Select a state to see its payment localities.

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.

Payment rules and modifiers for G0316

The CMS indicators that decide how G0316 is paid alongside other services.

Codes related to G0316

Related codes aren’t interchangeable: bill the code that matches the service performed.

How G0316 has changed in New Mexico

Price G0316 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

• Abeytas
• Abiquiu
• Acomita Lake
• Adelino
• Agua Fria
• Alamillo
• Alamo
• Alamogordo

Browse all communities in New Mexico

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

Open CMS sourceHow we calculate rates