Use G0084 for the 60-minute established-patient home-visit level; G0085 is the 75-minute level.
On this page
CMS RVU26D · Effective 2026-10-01
G0085 in Merced
Office / nonfacility
$222.48
Base rate per service
Facility setting
Not available in this setting
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Care management
About G0085: Established-patient care management home visit
Reports a 75-minute care-management home visit for an established patient, distinguished from shorter visit levels and the corresponding new-patient service.
G0085 represents an extended care-management visit in an established patient’s home. The clinician addresses the patient’s ongoing care needs during the home encounter. The code identifies both the established-patient status and the 75-minute service level; it differs from the new-patient home-visit level and from a home-care-plan service. The related established-patient visit codes describe shorter time levels.
Report G0085 when the patient is established, the service is a home visit for care management, and the documented time supports this level. Documentation should identify the patient’s status, the home setting, the care-management work performed, and the time associated with the visit. CMS values the service in the Physician Fee Schedule using physician-work, practice-expense, and malpractice RVUs.
Where the value comes from
- Work RVU4.09 · 63%
- Practice expense (office) RVU2.16 · 33%
- Malpractice RVU0.25 · 4%
240
Medicare services in 2024 · #4167 by national volume
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.
G0085 compared with similar codes
Office rates for Merced, from the same CMS release.
Both represent a 75-minute care-management home visit, but G0080 is for a new patient and G0085 is for an established patient.
G0086 identifies a home care plan service at 30 minutes; G0085 identifies a 75-minute established-patient care-management home visit.
The same code, a different location
How does Merced compare?
In Bakersfield, the office rate for G0085 is $223.36—$0.88 higher than the $222.48 rate in Merced. Both use the same code, release and participation basis.
G0085 across payment areas
Same release and payment basis · bars start at $0
Merced · This locality
$222.48
$223.36
$0.88 higher than Merced
$222.48
The same base rate than Merced
$222.52
$0.04 higher than Merced
$222.48
The same base rate than Merced
$222.48
The same base rate than Merced
$10.62 higher than Merced
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
Across 109 of 109 CMS payment localities with a supported office rate, G0085 ranges from $202.88 in Arkansas to $286.35 in Alaska*. This is a geographic range, not an average.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · G0085
Office
$222.48
Facility
Unavailable
The same base rate than Merced for the office setting.
Modesto
California · G0085
Office
$222.48
Facility
Unavailable
The same base rate than Merced for the office setting.
Napa
California · G0085
Office
$244.55
Facility
Unavailable
$22.07 higher than Merced for the office setting.
Oxnard-Thousand Oaks-Ventura
California · G0085
Office
$230.91
Facility
Unavailable
$8.43 higher than Merced for the office setting.
Redding
California · G0085
Office
$222.48
Facility
Unavailable
The same base rate than Merced for the office setting.
Rest Of California
California · G0085
Office
$222.48
Facility
Unavailable
The same base rate than Merced for the office setting.
Riverside-San Bernardino-Ontario
California · G0085
Office
$225.26
Facility
Unavailable
$2.78 higher than Merced for the office setting.
Sacramento-Roseville-Folsom
California · G0085
Office
$229.91
Facility
Unavailable
$7.43 higher than Merced for the office setting.
Salinas
California · G0085
Office
$228.94
Facility
Unavailable
$6.46 higher than Merced for the office setting.
San Diego-Chula Vista-Carlsbad
California · G0085
Office
$231.52
Facility
Unavailable
$9.04 higher than Merced for the office setting.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · G0085
Office
$255.15
Facility
Unavailable
$32.67 higher than Merced for the office setting.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · G0085
Office
$254.86
Facility
Unavailable
$32.38 higher than Merced for the office setting.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · G0085
Office
$260.15
Facility
Unavailable
$37.67 higher than Merced for the office setting.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · G0085
Office
$258.99
Facility
Unavailable
$36.51 higher than Merced for the office setting.
San Luis Obispo-Paso Robles
California · G0085
Office
$225.58
Facility
Unavailable
$3.10 higher than Merced for the office setting.
Santa Cruz-Watsonville
California · G0085
Office
$231.61
Facility
Unavailable
$9.13 higher than Merced for the office setting.
Santa Maria-Santa Barbara
California · G0085
Office
$229.03
Facility
Unavailable
$6.55 higher than Merced for the office setting.
Santa Rosa-Petaluma
California · G0085
Office
$233.78
Facility
Unavailable
$11.30 higher than Merced for the office setting.
Stockton
California · G0085
Office
$222.48
Facility
Unavailable
The same base rate than Merced for the office setting.
Vallejo
California · G0085
Office
$244.14
Facility
Unavailable
$21.66 higher than Merced for the office setting.
Visalia
California · G0085
Office
$222.48
Facility
Unavailable
The same base rate than Merced for the office setting.
Yuba City
California · G0085
Office
$222.48
Facility
Unavailable
The same base rate than Merced for the office setting.
Dc + Md/Va Suburbs
District of Columbia · G0085
Office
$238.27
Facility
Unavailable
$15.79 higher than Merced for the office setting.
Miami
Florida · G0085
Office
$232.83
Facility
Unavailable
$10.35 higher than Merced for the office setting.
Chicago
Illinois · G0085
Office
$229.24
Facility
Unavailable
$6.76 higher than Merced for the office setting.
Manhattan
New York · G0085
Office
$242.43
Facility
Unavailable
$19.95 higher than Merced for the office setting.
Alaska*
Alaska · G0085
Office
$286.35
Facility
Unavailable
$63.87 higher than Merced for the office setting.
Alabama
Alabama · G0085
Office
$204.46
Facility
Unavailable
$18.02 lower than Merced for the office setting.
Arkansas
Arkansas · G0085
Office
$202.88
Facility
Unavailable
$19.60 lower than Merced for the office setting.
Arizona
Arizona · G0085
Office
$213.67
Facility
Unavailable
$8.81 lower than Merced for the office setting.
Colorado
Colorado · G0085
Office
$221.53
Facility
Unavailable
$0.95 lower than Merced for the office setting.
Connecticut
Connecticut · G0085
Office
$227.15
Facility
Unavailable
$4.67 higher than Merced for the office setting.
Delaware
Delaware · G0085
Office
$216.08
Facility
Unavailable
$6.40 lower than Merced for the office setting.
Fort Lauderdale
Florida · G0085
Office
$224.79
Facility
Unavailable
$2.31 higher than Merced for the office setting.
Rest Of Florida
Florida · G0085
Office
$218.13
Facility
Unavailable
$4.35 lower than Merced for the office setting.
Atlanta
Georgia · G0085
Office
$220.35
Facility
Unavailable
$2.13 lower than Merced for the office setting.
Rest Of Georgia
Georgia · G0085
Office
$210.92
Facility
Unavailable
$11.56 lower than Merced for the office setting.
Hawaii, Guam
Hawaii · G0085
Office
$223.47
Facility
Unavailable
$0.99 higher than Merced for the office setting.
Iowa
Iowa · G0085
Office
$205.94
Facility
Unavailable
$16.54 lower than Merced for the office setting.
Idaho
Idaho · G0085
Office
$206.93
Facility
Unavailable
$15.55 lower than Merced for the office setting.
East St. Louis
Illinois · G0085
Office
$219.80
Facility
Unavailable
$2.68 lower than Merced for the office setting.
Rest Of Illinois
Illinois · G0085
Office
$215.53
Facility
Unavailable
$6.95 lower than Merced for the office setting.
Suburban Chicago
Illinois · G0085
Office
$226.46
Facility
Unavailable
$3.98 higher than Merced for the office setting.
Indiana
Indiana · G0085
Office
$207.55
Facility
Unavailable
$14.93 lower than Merced for the office setting.
Kansas
Kansas · G0085
Office
$206.04
Facility
Unavailable
$16.44 lower than Merced for the office setting.
Kentucky
Kentucky · G0085
Office
$208.39
Facility
Unavailable
$14.09 lower than Merced for the office setting.
New Orleans
Louisiana · G0085
Office
$213.98
Facility
Unavailable
$8.50 lower than Merced for the office setting.
Rest Of Louisiana
Louisiana · G0085
Office
$208.46
Facility
Unavailable
$14.02 lower than Merced for the office setting.
Metropolitan Boston
Massachusetts · G0085
Office
$235.78
Facility
Unavailable
$13.30 higher than Merced for the office setting.
Rest Of Massachusetts
Massachusetts · G0085
Office
$221.42
Facility
Unavailable
$1.06 lower than Merced for the office setting.
Baltimore/Surr. Cntys
Maryland · G0085
Office
$226.54
Facility
Unavailable
$4.06 higher than Merced for the office setting.
Rest Of Maryland
Maryland · G0085
Office
$218.65
Facility
Unavailable
$3.83 lower than Merced for the office setting.
Rest Of Maine
Maine · G0085
Office
$208.18
Facility
Unavailable
$14.30 lower than Merced for the office setting.
Southern Maine
Maine · G0085
Office
$213.38
Facility
Unavailable
$9.10 lower than Merced for the office setting.
Detroit
Michigan · G0085
Office
$220.31
Facility
Unavailable
$2.17 lower than Merced for the office setting.
Rest Of Michigan
Michigan · G0085
Office
$211.91
Facility
Unavailable
$10.57 lower than Merced for the office setting.
Minnesota
Minnesota · G0085
Office
$213.32
Facility
Unavailable
$9.16 lower than Merced for the office setting.
Metropolitan Kansas City
Missouri · G0085
Office
$212.51
Facility
Unavailable
$9.97 lower than Merced for the office setting.
Metropolitan St. Louis
Missouri · G0085
Office
$213.66
Facility
Unavailable
$8.82 lower than Merced for the office setting.
Rest Of Missouri
Missouri · G0085
Office
$206.93
Facility
Unavailable
$15.55 lower than Merced for the office setting.
Mississippi
Mississippi · G0085
Office
$204.90
Facility
Unavailable
$17.58 lower than Merced for the office setting.
Montana**
Montana · G0085
Office
$217.09
Facility
Unavailable
$5.39 lower than Merced for the office setting.
North Carolina
North Carolina · G0085
Office
$209.26
Facility
Unavailable
$13.22 lower than Merced for the office setting.
North Dakota**
North Dakota · G0085
Office
$212.15
Facility
Unavailable
$10.33 lower than Merced for the office setting.
Nebraska
Nebraska · G0085
Office
$206.36
Facility
Unavailable
$16.12 lower than Merced for the office setting.
New Hampshire
New Hampshire · G0085
Office
$219.02
Facility
Unavailable
$3.46 lower than Merced for the office setting.
Northern Nj
New Jersey · G0085
Office
$237.82
Facility
Unavailable
$15.34 higher than Merced for the office setting.
Rest Of New Jersey
New Jersey · G0085
Office
$230.02
Facility
Unavailable
$7.54 higher than Merced for the office setting.
New Mexico
New Mexico · G0085
Office
$212.80
Facility
Unavailable
$9.68 lower than Merced for the office setting.
Nevada**
Nevada · G0085
Office
$215.78
Facility
Unavailable
$6.70 lower than Merced for the office setting.
Nyc Suburbs/Long Island
New York · G0085
Office
$246.64
Facility
Unavailable
$24.16 higher than Merced for the office setting.
Poughkpsie/N Nyc Suburbs
New York · G0085
Office
$231.86
Facility
Unavailable
$9.38 higher than Merced for the office setting.
Queens
New York · G0085
Office
$242.67
Facility
Unavailable
$20.19 higher than Merced for the office setting.
Rest Of New York
New York · G0085
Office
$211.02
Facility
Unavailable
$11.46 lower than Merced for the office setting.
Ohio
Ohio · G0085
Office
$210.90
Facility
Unavailable
$11.58 lower than Merced for the office setting.
Oklahoma
Oklahoma · G0085
Office
$207.52
Facility
Unavailable
$14.96 lower than Merced for the office setting.
Portland
Oregon · G0085
Office
$225.16
Facility
Unavailable
$2.68 higher than Merced for the office setting.
Rest Of Oregon
Oregon · G0085
Office
$214.34
Facility
Unavailable
$8.14 lower than Merced for the office setting.
Metropolitan Philadelphia
Pennsylvania · G0085
Office
$224.13
Facility
Unavailable
$1.65 higher than Merced for the office setting.
Rest Of Pennsylvania
Pennsylvania · G0085
Office
$210.73
Facility
Unavailable
$11.75 lower than Merced for the office setting.
Puerto Rico
Puerto Rico · G0085
Office
$217.77
Facility
Unavailable
$4.71 lower than Merced for the office setting.
Rhode Island
Rhode Island · G0085
Office
$221.18
Facility
Unavailable
$1.30 lower than Merced for the office setting.
South Carolina
South Carolina · G0085
Office
$210.37
Facility
Unavailable
$12.11 lower than Merced for the office setting.
South Dakota**
South Dakota · G0085
Office
$211.56
Facility
Unavailable
$10.92 lower than Merced for the office setting.
Tennessee
Tennessee · G0085
Office
$206.67
Facility
Unavailable
$15.81 lower than Merced for the office setting.
Austin
Texas · G0085
Office
$220.61
Facility
Unavailable
$1.87 lower than Merced for the office setting.
Beaumont
Texas · G0085
Office
$210.02
Facility
Unavailable
$12.46 lower than Merced for the office setting.
Brazoria
Texas · G0085
Office
$215.71
Facility
Unavailable
$6.77 lower than Merced for the office setting.
Dallas
Texas · G0085
Office
$216.86
Facility
Unavailable
$5.62 lower than Merced for the office setting.
Fort Worth
Texas · G0085
Office
$216.25
Facility
Unavailable
$6.23 lower than Merced for the office setting.
Galveston
Texas · G0085
Office
$216.26
Facility
Unavailable
$6.22 lower than Merced for the office setting.
Houston
Texas · G0085
Office
$220.83
Facility
Unavailable
$1.65 lower than Merced for the office setting.
Rest Of Texas
Texas · G0085
Office
$212.62
Facility
Unavailable
$9.86 lower than Merced for the office setting.
Utah
Utah · G0085
Office
$211.93
Facility
Unavailable
$10.55 lower than Merced for the office setting.
Virginia
Virginia · G0085
Office
$213.42
Facility
Unavailable
$9.06 lower than Merced for the office setting.
Virgin Islands
United States Virgin Islands · G0085
Office
$217.77
Facility
Unavailable
$4.71 lower than Merced for the office setting.
Vermont
Vermont · G0085
Office
$212.26
Facility
Unavailable
$10.22 lower than Merced for the office setting.
Rest Of Washington
Washington · G0085
Office
$220.71
Facility
Unavailable
$1.77 lower than Merced for the office setting.
Seattle (King Cnty)
Washington · G0085
Office
$238.79
Facility
Unavailable
$16.31 higher than Merced for the office setting.
Wisconsin
Wisconsin · G0085
Office
$208.30
Facility
Unavailable
$14.18 lower than Merced for the office setting.
West Virginia
West Virginia · G0085
Office
$211.25
Facility
Unavailable
$11.23 lower than Merced for the office setting.
Wyoming**
Wyoming · G0085
Office
$214.93
Facility
Unavailable
$7.55 lower than Merced for the office setting.
See how rates vary across the country
G0085 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$202.88
$286.35
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $286.35 | 1 |
| AL | $204.46 | 1 |
| AR | $202.88 | 1 |
| AZ | $213.67 | 1 |
| CA | $222.48–$260.15 | 29 |
| CO | $221.53 | 1 |
| CT | $227.15 | 1 |
| DC | $238.27 | 1 |
| DE | $216.08 | 1 |
| FL | $218.13–$232.83 | 3 |
| GA | $210.92–$220.35 | 2 |
| GU | $223.47 | 1 |
| HI | $223.47 | 1 |
| IA | $205.94 | 1 |
| ID | $206.93 | 1 |
| IL | $215.53–$229.24 | 4 |
| IN | $207.55 | 1 |
| KS | $206.04 | 1 |
| KY | $208.39 | 1 |
| LA | $208.46–$213.98 | 2 |
| MA | $221.42–$235.78 | 2 |
| MD | $218.65–$238.27 | 3 |
| ME | $208.18–$213.38 | 2 |
| MI | $211.91–$220.31 | 2 |
| MN | $213.32 | 1 |
| MO | $206.93–$213.66 | 3 |
| MS | $204.90 | 1 |
| MT | $217.09 | 1 |
| NC | $209.26 | 1 |
| ND | $212.15 | 1 |
| NE | $206.36 | 1 |
| NH | $219.02 | 1 |
| NJ | $230.02–$237.82 | 2 |
| NM | $212.80 | 1 |
| NV | $215.78 | 1 |
| NY | $211.02–$246.64 | 5 |
| OH | $210.90 | 1 |
| OK | $207.52 | 1 |
| OR | $214.34–$225.16 | 2 |
| PA | $210.73–$224.13 | 2 |
| PR | $217.77 | 1 |
| RI | $221.18 | 1 |
| SC | $210.37 | 1 |
| SD | $211.56 | 1 |
| TN | $206.67 | 1 |
| TX | $210.02–$220.83 | 8 |
| UT | $211.93 | 1 |
| VA | $213.42–$238.27 | 2 |
| VI | $217.77 | 1 |
| VT | $212.26 | 1 |
| WA | $220.71–$238.79 | 2 |
| WI | $208.30 | 1 |
| WV | $211.25 | 1 |
| WY | $214.93 | 1 |
Where does this rate apply?
Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for G0085 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$244.73
$222.48 × 110% = $244.73
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for G0085 in Merced.
PPRRVU2026_Oct_nonQPP.csv
15,077
- Code
- G0085
- Physician work
- 4.09
- Practice expense
- 2.16
- Malpractice
- 0.25
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.09 | × 1.017 | 4.1595 |
| Practice expense | 2.16 | × 1.096 | 2.3674 |
| Malpractice | 0.25 | × 0.536 | 0.1340 |
| Total RVUs | 6.6609 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Merced$222.48
Open G0085 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.09 | 1.017 |
| Practice expense | 2.16 | 1.096 |
| Malpractice | 0.25 | 0.536 |
(4.09 × 1.017 + 2.16 × 1.096 + 0.25 × 0.536) × $33.4009 = $222.48
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
G0085 · Office / nonfacility
$222.48
Effective 2026-10-01
The base rate is $18.04 higher than on 2025-10-01, moving from $204.44 to $222.48 (8.8%).
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
$204.44changed to$222.48
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 1.86 changed to 2.16
- Work GPCI 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.560 changed to 0.536
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: $204.44
Held through RVU25B, RVU25C, RVU25D.
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $222.48 | Not available in this setting | RVU26D |
| 2026-07-01 | $222.48 | Not available in this setting | RVU26C |
| 2026-04-01 | $222.48 | Not available in this setting | RVU26B |
| 2026-01-01 | $222.48 | Not available in this setting | RVU26A |
| 2025-10-01 | $204.44 | Not available in this setting | RVU25D |
| 2025-07-01 | $204.44 | Not available in this setting | RVU25C |
| 2025-04-01 | $204.44 | Not available in this setting | RVU25B |
| 2025-01-01 | $204.44 | Not available in this setting | RVU25A |
G0085 billing questions
How does G0085 differ from G0084?
Both describe care-management home visits for established patients. G0085 is the 75-minute level; G0084 is the 60-minute level.
Can G0085 be used for a new patient?
No. G0085 is the established-patient level. G0080 is the corresponding 75-minute home-visit level for a new patient.
What time should the documentation support?
The record should support the 75-minute service level and describe the care-management work performed during the home visit.
How is G0085 different from G0086?
G0085 describes an established-patient care-management home visit. G0086 describes a home care plan service at the 30-minute level.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
