HCPCS code G2212: Prolonged office visit, medicare add-on, each 15 minutes2026 Medicare rate & RVUs

Medicare pays $34.07 for G2212 nationally in the office and $27.39 in a hospital or facility. Local office rates run $31.56–$44.29.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What G2212 covers

G2212 captures prolonged physician or qualified health care professional work for a new or established level 5 office or outpatient E/M visit selected by total time. Time on the service date may include reviewing outside records, examining and counseling the patient, discussing treatment with other clinicians, and documenting the encounter, whether or not the patient is present. Physicians, nurse practitioners, and physician assistants may report it in primary care or specialty clinics and hospital outpatient departments when extensive record review and extended counseling make a visit unusually long.

Report G2212 with 99205 or 99215; Medicare uses it instead of CPT 99417 for these prolonged visits. Current CPT sets a minimum of 60 minutes for 99205 and 40 minutes for 99215. Under Medicare's prolonged-time thresholds, the first G2212 unit begins at 89 total minutes with 99205 or 69 with 99215; another unit begins after each further 15 minutes. Document total practitioner time on the date and the work performed. Exclude clinical staff time and time spent on separately reported services.

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.

Where G2212 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

G2212 rates by state

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

How the G2212 rate is calculated

Each of G2212’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 G2212

G2212 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.

G2212 compared with similar codes

How to choose

99417Prolonged E/MOffice or outpatient

Both describe prolonged time with a time-based 99205 or 99215, but they use different reporting thresholds. Medicare uses G2212 for these visits; some non-Medicare payers use CPT 99417.

G2211Visit complexity add-onOngoing longitudinal patient relationship

G2211 reflects visit complexity tied to an ongoing care relationship or care for a serious condition. G2212 requires prolonged practitioner time beyond a time-based level 5 visit.

G0316Prolonged E/MInpatient or observation care

G0316 addresses prolonged hospital inpatient or observation E/M care. G2212 is reported with a qualifying office or outpatient visit coded 99205 or 99215.

Codes related to G2212

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

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