HCPCS code G3003: Pain management, each additional 15 minutes2026 Medicare rate & RVUs in Puerto Rico
Reports each additional 15 minutes of structured chronic pain management after the initial monthly service for a patient receiving ongoing, coordinated pain care.
In Puerto Rico, Medicare pays $31.85 for G3003 in the office and $22.74 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · G3003 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 G3003 covers
G3003 represents additional clinician time spent managing a patient’s chronic pain after the initial service. A physician or other qualified health care professional may use this time to review pain and treatment progress, update the person-centered care plan, manage medications, address pain-related needs, and coordinate relevant behavioral health, therapy, or community-based services. The work is part of ongoing chronic pain care rather than a stand-alone procedure.
Report G3003 only with the primary chronic pain management service, G3002, for additional 15-minute increments. Documentation should identify the chronic pain management work performed and support the additional time reported. CMS classifies G3003 as an add-on code: it is billed with the primary service and paid within that service’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 Puerto Rico compares for G3003
Across 109 of 109 payment localities, the office rate for G3003 runs from $29.04 in Arkansas to $40.20 in Alaska. Puerto Rico pays $31.85. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$31.85
- Los Angeles, CA · California$34.30+$2.45
- Washington, DC area · District of Columbia$35.20+$3.35
- Miami, FL · Florida$34.83+$2.98
- Chicago, IL · Illinois$34.08+$2.23
- Manhattan, NY · New York$35.94+$4.09
- Alaska · Alaska$40.20+$8.35
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $29.34 | $21.45 |
| ArkansasArkansas | $29.04 | $21.29 |
| ArizonaArizona | $31.08 | $22.34 |
| Bakersfield, CACalifornia | $32.68 | $22.79 |
| Chico, CACalifornia | $32.52 | $22.64 |
| El Centro, CACalifornia | $32.53 | $22.65 |
| Fresno, CACalifornia | $32.52 | $22.64 |
| Hanford, CACalifornia | $32.52 | $22.64 |
| Madera, CACalifornia | $32.52 | $22.64 |
| Merced, CACalifornia | $32.52 | $22.64 |
| Modesto, CACalifornia | $32.52 | $22.64 |
| Napa, CACalifornia | $36.21 | $24.32 |
| Oxnard, CACalifornia | $34.00 | $23.34 |
| Redding, CACalifornia | $32.52 | $22.64 |
| Rest of CaliforniaCalifornia | $32.52 | $22.64 |
| Riverside, CACalifornia | $33.07 | $23.18 |
| Sacramento, CACalifornia | $33.73 | $23.25 |
| Salinas, CACalifornia | $33.60 | $23.15 |
| San Diego, CACalifornia | $34.09 | $23.30 |
| Marin County, CACalifornia | $37.89 | $25.18 |
| San Francisco, CACalifornia | $37.83 | $25.12 |
| San Benito County, CACalifornia | $38.70 | $25.69 |
| Santa Clara County, CACalifornia | $38.47 | $25.46 |
| San Luis Obispo, CACalifornia | $33.10 | $22.83 |
| Santa Cruz, CACalifornia | $34.18 | $23.22 |
| Santa Maria, CACalifornia | $33.64 | $23.13 |
| Santa Rosa, CACalifornia | $34.50 | $23.43 |
| Stockton, CACalifornia | $32.52 | $22.64 |
| Vallejo, CACalifornia | $36.13 | $24.24 |
| Visalia, CACalifornia | $32.52 | $22.64 |
| Yuba City, CACalifornia | $32.52 | $22.64 |
| ColoradoColorado | $32.42 | $22.83 |
| ConnecticutConnecticut | $33.44 | $23.73 |
| DelawareDelaware | $31.49 | $22.58 |
| Fort Lauderdale, FLFlorida | $33.25 | $24.12 |
| Rest of FloridaFlorida | $31.98 | $23.36 |
| Atlanta, GAGeorgia | $32.33 | $23.17 |
| Rest of GeorgiaGeorgia | $30.61 | $22.56 |
| Hawaii, Guam, HIHawaii | $32.86 | $22.60 |
| IowaIowa | $29.59 | $21.34 |
| IdahoIdaho | $29.78 | $21.49 |
| East St. Louis, ILIllinois | $32.36 | $24.06 |
| Rest of IllinoisIllinois | $31.51 | $23.28 |
| Suburban Chicago, ILIllinois | $33.50 | $24.24 |
| IndianaIndiana | $29.90 | $21.54 |
| KansasKansas | $29.62 | $21.47 |
| KentuckyKentucky | $30.11 | $22.09 |
| New Orleans, LALouisiana | $31.17 | $22.68 |
| Rest of LouisianaLouisiana | $30.12 | $22.14 |
| Metropolitan Boston, MAMassachusetts | $34.82 | $24.06 |
| Rest of MassachusettsMassachusetts | $32.37 | $22.87 |
| Baltimore area, MDMaryland | $33.37 | $23.69 |
| Rest of MarylandMaryland | $31.92 | $22.79 |
| Rest of MaineMaine | $30.03 | $21.73 |
| Southern Maine, MEMaine | $30.99 | $22.06 |
| Detroit, MIMichigan | $32.41 | $23.71 |
| Rest of MichiganMichigan | $30.78 | $22.55 |
| MinnesotaMinnesota | $30.94 | $21.66 |
| Metropolitan Kansas City, MOMissouri | $30.88 | $22.41 |
| Metropolitan St. Louis, MOMissouri | $31.09 | $22.51 |
| Rest of MissouriMissouri | $29.84 | $22.07 |
| MississippiMississippi | $29.44 | $21.67 |
| MontanaMontana | $31.73 | $22.71 |
| North CarolinaNorth Carolina | $30.23 | $21.82 |
| North DakotaNorth Dakota | $30.74 | $21.72 |
| NebraskaNebraska | $29.66 | $21.34 |
| New HampshireNew Hampshire | $32.07 | $22.68 |
| Northern New JerseyNew Jersey | $35.03 | $24.57 |
| Rest of New JerseyNew Jersey | $33.79 | $23.94 |
| New MexicoNew Mexico | $30.96 | $22.69 |
| NevadaNevada | $31.47 | $22.44 |
| NYC suburbs and Long Island, NYNew York | $36.76 | $26.03 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $34.10 | $24.23 |
| Queens, NYNew York | $35.97 | $25.31 |
| Rest of New YorkNew York | $30.57 | $22.00 |
| OhioOhio | $30.58 | $22.35 |
| OklahomaOklahoma | $29.93 | $21.88 |
| Portland, OROregon | $33.05 | $23.03 |
| Rest of OregonOregon | $31.18 | $22.20 |
| Metropolitan Philadelphia, PAPennsylvania | $32.90 | $23.51 |
| Rest of PennsylvaniaPennsylvania | $30.54 | $22.26 |
| Rhode IslandRhode Island | $32.31 | $22.99 |
| South CarolinaSouth Carolina | $30.46 | $22.13 |
| South DakotaSouth Dakota | $30.62 | $21.60 |
| TennesseeTennessee | $29.74 | $21.54 |
| Austin, TXTexas | $32.35 | $22.81 |
| Beaumont, TXTexas | $30.41 | $22.20 |
| Brazoria, TXTexas | $31.38 | $22.44 |
| Dallas, TXTexas | $31.59 | $22.61 |
| Fort Worth, TXTexas | $31.48 | $22.59 |
| Galveston, TXTexas | $31.48 | $22.53 |
| Houston, TXTexas | $32.40 | $23.44 |
| Rest of TexasTexas | $30.89 | $22.33 |
| UtahUtah | $30.76 | $22.28 |
| VirginiaVirginia | $31.01 | $22.15 |
| Virgin Islands, VIUnited States Virgin Islands | $31.85 | $22.74 |
| VermontVermont | $30.77 | $21.84 |
| Rest of WashingtonWashington | $32.26 | $22.76 |
| King County, WAWashington | $35.29 | $24.23 |
| WisconsinWisconsin | $30.01 | $21.37 |
| West VirginiaWest Virginia | $30.70 | $22.86 |
| WyomingWyoming | $31.30 | $22.28 |
G3003 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.
$29.04
$40.20
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 | $40.20 | 1 |
| AL | $29.34 | 1 |
| AR | $29.04 | 1 |
| AZ | $31.08 | 1 |
| CA | $32.52–$38.70 | 29 |
| CO | $32.42 | 1 |
| CT | $33.44 | 1 |
| DC | $35.20 | 1 |
| DE | $31.49 | 1 |
| FL | $31.98–$34.83 | 3 |
| GA | $30.61–$32.33 | 2 |
| GU | $32.86 | 1 |
| HI | $32.86 | 1 |
| IA | $29.59 | 1 |
| ID | $29.78 | 1 |
| IL | $31.51–$34.08 | 4 |
| IN | $29.90 | 1 |
| KS | $29.62 | 1 |
| KY | $30.11 | 1 |
| LA | $30.12–$31.17 | 2 |
| MA | $32.37–$34.82 | 2 |
| MD | $31.92–$35.20 | 3 |
| ME | $30.03–$30.99 | 2 |
| MI | $30.78–$32.41 | 2 |
| MN | $30.94 | 1 |
| MO | $29.84–$31.09 | 3 |
| MS | $29.44 | 1 |
| MT | $31.73 | 1 |
| NC | $30.23 | 1 |
| ND | $30.74 | 1 |
| NE | $29.66 | 1 |
| NH | $32.07 | 1 |
| NJ | $33.79–$35.03 | 2 |
| NM | $30.96 | 1 |
| NV | $31.47 | 1 |
| NY | $30.57–$36.76 | 5 |
| OH | $30.58 | 1 |
| OK | $29.93 | 1 |
| OR | $31.18–$33.05 | 2 |
| PA | $30.54–$32.90 | 2 |
| PR | $31.85 | 1 |
| RI | $32.31 | 1 |
| SC | $30.46 | 1 |
| SD | $30.62 | 1 |
| TN | $29.74 | 1 |
| TX | $30.41–$32.40 | 8 |
| UT | $30.76 | 1 |
| VA | $31.01–$35.20 | 2 |
| VI | $31.85 | 1 |
| VT | $30.77 | 1 |
| WA | $32.26–$35.29 | 2 |
| WI | $30.01 | 1 |
| WV | $30.70 | 1 |
| WY | $31.30 | 1 |
How the G3003 rate is calculated
Each of G3003’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 · G3003
RVUs × geographic indexes × conversion factor
Work0.50
0.50 RVUs× 1.000 GPCI
Practice expense0.40
0.40 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
0.9500
Conversion factor
$33.4009
Medicare rate
$31.73
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
15,536
- Code
- G3003
- Physician work
- 0.50
- Practice expense
- 0.40
- Malpractice
- 0.05
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.50 | × 1.000 | 0.5000 |
| Practice expense | 0.40 | × 1.011 | 0.4044 |
| Malpractice | 0.05 | × 0.985 | 0.0493 |
| Total RVUs | 0.9536 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$31.85
Office: (0.5 × 1 + 0.4 × 1.011 + 0.05 × 0.985) × $33.4009 = $31.85
Facility: (0.5 × 1 + 0.13 × 1.011 + 0.05 × 0.985) × $33.4009 = $22.74
Payment rules and modifiers for G3003
The CMS indicators that decide how G3003 is paid alongside other services.
CMS payment indicators · G3003
Pain management, each additional 15 minutes
| 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 G3003 has changed in Puerto Rico
G3003 · Office / nonfacility
$31.85
Effective 2026-10-01
The base rate is $2.35 higher than on 2025-10-01, moving from $29.50 to $31.85 (8.0%).
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
$29.50changed to$31.85
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.37 changed to 0.40
- Malpractice RVU 0.04 changed to 0.05
- Practice expense GPCI 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$30.35changed to$29.50
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$29.86changed to$30.35
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$29.55changed to$29.86
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.33 changed to 0.37
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$29.48changed to$29.55
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
No ratechanged to$29.48
Held through RVU23B, RVU23C.
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 | $31.85 | $22.74 | RVU26D |
| 2026-07-01 | $31.85 | $22.74 | RVU26C |
| 2026-04-01 | $31.85 | $22.74 | RVU26B |
| 2026-01-01 | $31.85 | $22.74 | RVU26A |
| 2025-10-01 | $29.50 | $24.94 | RVU25D |
| 2025-07-01 | $29.50 | $24.94 | RVU25C |
| 2025-04-01 | $29.50 | $24.94 | RVU25B |
| 2025-01-01 | $29.50 | $24.94 | RVU25A |
| 2024-10-01 | $30.35 | $25.66 | RVU24D |
| 2024-07-01 | $30.35 | $25.66 | RVU24C |
| 2024-04-01 | $30.35 | $25.66 | RVU24B |
| 2024-03-09 | $30.35 | $25.66 | RVU24AR |
| 2024-01-01 | $29.86 | $25.24 | RVU24A |
| 2023-10-01 | $29.55 | $25.45 | RVU23D |
| 2023-07-01 | $29.48 | $25.42 | RVU23C |
| 2023-04-01 | $29.48 | $25.42 | RVU23B |
| 2023-01-01 | $29.48 | $25.42 | 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 Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
G3003 billing questions
When should G3003 be reported instead of G3002?
G3002 represents the initial chronic pain management service. G3003 is for additional 15-minute increments and is reported only with G3002.
What should the record support for G3003?
Document the additional time and the chronic pain management work performed, such as care-plan updates, medication management, or coordination of related services.
Can G3003 be billed by itself?
No. It is an add-on code and must be billed with the primary service, G3002.
How many units of G3003 should be reported?
Report units for the additional 15-minute increments supported by the documented chronic pain management time.
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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