HCPCS code G2211: Visit complexity add-on2026 Medicare rate & RVUs

Medicare pays $17.37 for G2211 nationally in the office and $14.36 in a hospital or facility. Local office rates run $16.24–$22.95.

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

What G2211 covers

G2211 recognizes the extra cognitive work of being responsible for a patient over time, not the difficulty of a single encounter. It applies when the billing practitioner is the continuing focal point for all of the patient's needed services, as primary care physicians, nurse practitioners, and physician assistants typically are, or provides ongoing care for a single serious or complex condition. Examples include an endocrinologist managing a patient's diabetes or an infectious disease physician following a patient with HIV. It is reported for office and outpatient visits, including those furnished by telehealth.

Report one unit with a new or established patient office or outpatient E/M code (99202-99215). Documentation should support the longitudinal relationship, such as an ongoing care plan, chronic condition management, or the practitioner's role in coordinating the patient's care. The relationship can begin with a new patient visit when ongoing care is expected. It does not fit a one-time or time-limited episode. As an add-on, G2211 is billed only with its primary E/M and paid within that service's global period. It is generally not payable when the base E/M carries modifier 25, except when that visit is reported on the same day as an annual wellness visit, vaccine administration, or a Medicare Part B preventive service.

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 G2211 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

G2211 rates by state

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

How the G2211 rate is calculated

Each of G2211’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 G2211

The CMS indicators that decide how G2211 is paid alongside other services.

G2211 compared with similar codes

How to choose

G2212Prolonged office visit

G2212 is time-based and adds payment for extended time beyond a 99205 or 99215 threshold; G2211 is not time-based and reflects the ongoing practitioner-patient relationship.

99490Chronic care management

99490 pays for monthly non-face-to-face chronic care management staff time; G2211 is attached to an in-person or telehealth office visit and recognizes longitudinal work inherent in that visit.

99214Office visit

99214 is the visit itself, leveled by medical decision making or time; G2211 never stands alone and is appended only when longitudinal care criteria are documented.

Codes related to G2211

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