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CMS RVU26D · Effective 2026-10-01

G2004 in Merced

Office / nonfacility

$167.46

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.

Home-based evaluation and management

About G2004: Post-discharge home visit, new patient, 60 minutes

Reports a 60-minute post-discharge home evaluation and management visit for a beneficiary who qualifies as a new patient.

G2004 describes a home visit after a beneficiary’s discharge, with the service documented at the 60-minute level for a new patient. A physician or other qualified health care professional assesses the beneficiary in the residence, such as during recovery after a hospital stay. The encounter may address current symptoms, medication use, mobility, support at home, and the need for further care.

Choose the new-patient series when the beneficiary meets the applicable new-patient definition; use the established-patient series otherwise. Document the discharge context, home setting, new-patient status, time supporting the selected level, clinical assessment, and plan. CMS assigns the code work, practice-expense, and malpractice relative value units under the Physician Fee Schedule. G2003 and G2005 are the neighboring new-patient levels for 45 and 75 minutes, respectively.

Where the value comes from

  • Work RVU3.38 · 69%
  • Practice expense (office) RVU1.36 · 28%
  • Malpractice RVU0.16 · 3%

12

Medicare services in 2024 · #6155 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.

G2004 compared with similar codes

Office rates for Merced, from the same CMS release.

G2003

Home visit

New patient, 45 minutes

$122.87

G2003 is the 45-minute new-patient post-discharge home-visit level; G2004 is the 60-minute level.

G2005

Home visit

New patient, 75 minutes

$222.48

G2005 is the 75-minute new-patient post-discharge home-visit level; G2004 is the 60-minute level.

G2009

Home visit

Established patient, 60 minutes

$186.73

G2009 is for an established patient at the 60-minute level. G2004 is the corresponding new-patient level.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for G2004 is $168.08—$0.62 higher than the $167.46 rate in Merced. Both use the same code, release and participation basis.

G2004 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $167.46

  2. $0.62 higher than Merced

  3. Chico

    $167.46

    The same base rate than Merced

  4. El Centro

    $167.49

    $0.03 higher than Merced

  5. Fresno

    $167.46

    The same base rate than Merced

  6. The same base rate than Merced

  7. $7.35 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, G2004 ranges from $154.67 in Arkansas to $220.67 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 · G2004

    Office

    $167.46

    Facility

    Unavailable

    The same base rate than Merced for the office setting.

  • Modesto

    California · G2004

    Office

    $167.46

    Facility

    Unavailable

    The same base rate than Merced for the office setting.

  • Napa

    California · G2004

    Office

    $182.59

    Facility

    Unavailable

    $15.13 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · G2004

    Office

    $173.08

    Facility

    Unavailable

    $5.62 higher than Merced for the office setting.

  • Redding

    California · G2004

    Office

    $167.46

    Facility

    Unavailable

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · G2004

    Office

    $167.46

    Facility

    Unavailable

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · G2004

    Office

    $169.27

    Facility

    Unavailable

    $1.81 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · G2004

    Office

    $172.65

    Facility

    Unavailable

    $5.19 higher than Merced for the office setting.

  • Salinas

    California · G2004

    Office

    $171.91

    Facility

    Unavailable

    $4.45 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · G2004

    Office

    $173.51

    Facility

    Unavailable

    $6.05 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · G2004

    Office

    $190.12

    Facility

    Unavailable

    $22.66 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · G2004

    Office

    $189.94

    Facility

    Unavailable

    $22.48 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · G2004

    Office

    $193.68

    Facility

    Unavailable

    $26.22 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · G2004

    Office

    $192.94

    Facility

    Unavailable

    $25.48 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · G2004

    Office

    $169.42

    Facility

    Unavailable

    $1.96 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · G2004

    Office

    $173.32

    Facility

    Unavailable

    $5.86 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · G2004

    Office

    $171.89

    Facility

    Unavailable

    $4.43 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · G2004

    Office

    $174.93

    Facility

    Unavailable

    $7.47 higher than Merced for the office setting.

  • Stockton

    California · G2004

    Office

    $167.46

    Facility

    Unavailable

    The same base rate than Merced for the office setting.

  • Vallejo

    California · G2004

    Office

    $182.33

    Facility

    Unavailable

    $14.87 higher than Merced for the office setting.

  • Visalia

    California · G2004

    Office

    $167.46

    Facility

    Unavailable

    The same base rate than Merced for the office setting.

  • Yuba City

    California · G2004

    Office

    $167.46

    Facility

    Unavailable

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · G2004

    Office

    $178.45

    Facility

    Unavailable

    $10.99 higher than Merced for the office setting.

  • Miami

    Florida · G2004

    Office

    $173.70

    Facility

    Unavailable

    $6.24 higher than Merced for the office setting.

  • Chicago

    Illinois · G2004

    Office

    $171.60

    Facility

    Unavailable

    $4.14 higher than Merced for the office setting.

  • Manhattan

    New York · G2004

    Office

    $181.38

    Facility

    Unavailable

    $13.92 higher than Merced for the office setting.

  • Alaska*

    Alaska · G2004

    Office

    $220.67

    Facility

    Unavailable

    $53.21 higher than Merced for the office setting.

  • Alabama

    Alabama · G2004

    Office

    $155.67

    Facility

    Unavailable

    $11.79 lower than Merced for the office setting.

  • Arkansas

    Arkansas · G2004

    Office

    $154.67

    Facility

    Unavailable

    $12.79 lower than Merced for the office setting.

  • Arizona

    Arizona · G2004

    Office

    $161.49

    Facility

    Unavailable

    $5.97 lower than Merced for the office setting.

  • Colorado

    Colorado · G2004

    Office

    $166.76

    Facility

    Unavailable

    $0.70 lower than Merced for the office setting.

  • Connecticut

    Connecticut · G2004

    Office

    $170.54

    Facility

    Unavailable

    $3.08 higher than Merced for the office setting.

  • Delaware

    Delaware · G2004

    Office

    $163.14

    Facility

    Unavailable

    $4.32 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · G2004

    Office

    $168.57

    Facility

    Unavailable

    $1.11 higher than Merced for the office setting.

  • Rest Of Florida

    Florida · G2004

    Office

    $164.35

    Facility

    Unavailable

    $3.11 lower than Merced for the office setting.

  • Atlanta

    Georgia · G2004

    Office

    $165.80

    Facility

    Unavailable

    $1.66 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · G2004

    Office

    $159.78

    Facility

    Unavailable

    $7.68 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · G2004

    Office

    $167.64

    Facility

    Unavailable

    $0.18 higher than Merced for the office setting.

  • Iowa

    Iowa · G2004

    Office

    $156.58

    Facility

    Unavailable

    $10.88 lower than Merced for the office setting.

  • Idaho

    Idaho · G2004

    Office

    $157.21

    Facility

    Unavailable

    $10.25 lower than Merced for the office setting.

  • East St. Louis

    Illinois · G2004

    Office

    $165.45

    Facility

    Unavailable

    $2.01 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · G2004

    Office

    $162.72

    Facility

    Unavailable

    $4.74 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · G2004

    Office

    $169.81

    Facility

    Unavailable

    $2.35 higher than Merced for the office setting.

  • Indiana

    Indiana · G2004

    Office

    $157.60

    Facility

    Unavailable

    $9.86 lower than Merced for the office setting.

  • Kansas

    Kansas · G2004

    Office

    $156.65

    Facility

    Unavailable

    $10.81 lower than Merced for the office setting.

  • Kentucky

    Kentucky · G2004

    Office

    $158.17

    Facility

    Unavailable

    $9.29 lower than Merced for the office setting.

  • New Orleans

    Louisiana · G2004

    Office

    $161.71

    Facility

    Unavailable

    $5.75 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · G2004

    Office

    $158.22

    Facility

    Unavailable

    $9.24 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · G2004

    Office

    $176.52

    Facility

    Unavailable

    $9.06 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · G2004

    Office

    $166.79

    Facility

    Unavailable

    $0.67 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · G2004

    Office

    $170.05

    Facility

    Unavailable

    $2.59 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · G2004

    Office

    $164.90

    Facility

    Unavailable

    $2.56 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · G2004

    Office

    $158.01

    Facility

    Unavailable

    $9.45 lower than Merced for the office setting.

  • Southern Maine

    Maine · G2004

    Office

    $161.28

    Facility

    Unavailable

    $6.18 lower than Merced for the office setting.

  • Detroit

    Michigan · G2004

    Office

    $165.74

    Facility

    Unavailable

    $1.72 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · G2004

    Office

    $160.40

    Facility

    Unavailable

    $7.06 lower than Merced for the office setting.

  • Minnesota

    Minnesota · G2004

    Office

    $161.22

    Facility

    Unavailable

    $6.24 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · G2004

    Office

    $160.77

    Facility

    Unavailable

    $6.69 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · G2004

    Office

    $161.49

    Facility

    Unavailable

    $5.97 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · G2004

    Office

    $157.26

    Facility

    Unavailable

    $10.20 lower than Merced for the office setting.

  • Mississippi

    Mississippi · G2004

    Office

    $155.96

    Facility

    Unavailable

    $11.50 lower than Merced for the office setting.

  • Montana**

    Montana · G2004

    Office

    $163.65

    Facility

    Unavailable

    $3.81 lower than Merced for the office setting.

  • North Carolina

    North Carolina · G2004

    Office

    $158.69

    Facility

    Unavailable

    $8.77 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · G2004

    Office

    $160.49

    Facility

    Unavailable

    $6.97 lower than Merced for the office setting.

  • Nebraska

    Nebraska · G2004

    Office

    $156.84

    Facility

    Unavailable

    $10.62 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · G2004

    Office

    $164.86

    Facility

    Unavailable

    $2.60 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · G2004

    Office

    $178.41

    Facility

    Unavailable

    $10.95 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · G2004

    Office

    $172.88

    Facility

    Unavailable

    $5.42 higher than Merced for the office setting.

  • New Mexico

    New Mexico · G2004

    Office

    $160.97

    Facility

    Unavailable

    $6.49 lower than Merced for the office setting.

  • Nevada**

    Nevada · G2004

    Office

    $162.82

    Facility

    Unavailable

    $4.64 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · G2004

    Office

    $184.05

    Facility

    Unavailable

    $16.59 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · G2004

    Office

    $174.18

    Facility

    Unavailable

    $6.72 higher than Merced for the office setting.

  • Queens

    New York · G2004

    Office

    $181.52

    Facility

    Unavailable

    $14.06 higher than Merced for the office setting.

  • Rest Of New York

    New York · G2004

    Office

    $159.81

    Facility

    Unavailable

    $7.65 lower than Merced for the office setting.

  • Ohio

    Ohio · G2004

    Office

    $159.76

    Facility

    Unavailable

    $7.70 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · G2004

    Office

    $157.61

    Facility

    Unavailable

    $9.85 lower than Merced for the office setting.

  • Portland

    Oregon · G2004

    Office

    $169.14

    Facility

    Unavailable

    $1.68 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · G2004

    Office

    $161.90

    Facility

    Unavailable

    $5.56 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · G2004

    Office

    $168.59

    Facility

    Unavailable

    $1.13 higher than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · G2004

    Office

    $159.65

    Facility

    Unavailable

    $7.81 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · G2004

    Office

    $164.08

    Facility

    Unavailable

    $3.38 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · G2004

    Office

    $166.73

    Facility

    Unavailable

    $0.73 lower than Merced for the office setting.

  • South Carolina

    South Carolina · G2004

    Office

    $159.41

    Facility

    Unavailable

    $8.05 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · G2004

    Office

    $160.12

    Facility

    Unavailable

    $7.34 lower than Merced for the office setting.

  • Tennessee

    Tennessee · G2004

    Office

    $157.06

    Facility

    Unavailable

    $10.40 lower than Merced for the office setting.

  • Austin

    Texas · G2004

    Office

    $165.92

    Facility

    Unavailable

    $1.54 lower than Merced for the office setting.

  • Beaumont

    Texas · G2004

    Office

    $159.20

    Facility

    Unavailable

    $8.26 lower than Merced for the office setting.

  • Brazoria

    Texas · G2004

    Office

    $162.98

    Facility

    Unavailable

    $4.48 lower than Merced for the office setting.

  • Dallas

    Texas · G2004

    Office

    $163.74

    Facility

    Unavailable

    $3.72 lower than Merced for the office setting.

  • Fort Worth

    Texas · G2004

    Office

    $163.36

    Facility

    Unavailable

    $4.10 lower than Merced for the office setting.

  • Galveston

    Texas · G2004

    Office

    $163.33

    Facility

    Unavailable

    $4.13 lower than Merced for the office setting.

  • Houston

    Texas · G2004

    Office

    $166.26

    Facility

    Unavailable

    $1.20 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · G2004

    Office

    $160.83

    Facility

    Unavailable

    $6.63 lower than Merced for the office setting.

  • Utah

    Utah · G2004

    Office

    $160.39

    Facility

    Unavailable

    $7.07 lower than Merced for the office setting.

  • Virginia

    Virginia · G2004

    Office

    $161.32

    Facility

    Unavailable

    $6.14 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · G2004

    Office

    $164.08

    Facility

    Unavailable

    $3.38 lower than Merced for the office setting.

  • Vermont

    Vermont · G2004

    Office

    $160.57

    Facility

    Unavailable

    $6.89 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · G2004

    Office

    $166.26

    Facility

    Unavailable

    $1.20 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · G2004

    Office

    $178.64

    Facility

    Unavailable

    $11.18 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · G2004

    Office

    $158.06

    Facility

    Unavailable

    $9.40 lower than Merced for the office setting.

  • West Virginia

    West Virginia · G2004

    Office

    $160.02

    Facility

    Unavailable

    $7.44 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · G2004

    Office

    $162.27

    Facility

    Unavailable

    $5.19 lower than Merced for the office setting.

See how rates vary across the country

G2004 · 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.

$154.67

$220.67

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$220.671
AL$155.671
AR$154.671
AZ$161.491
CA$167.46–$193.6829
CO$166.761
CT$170.541
DC$178.451
DE$163.141
FL$164.35–$173.703
GA$159.78–$165.802
GU$167.641
HI$167.641
IA$156.581
ID$157.211
IL$162.72–$171.604
IN$157.601
KS$156.651
KY$158.171
LA$158.22–$161.712
MA$166.79–$176.522
MD$164.90–$178.453
ME$158.01–$161.282
MI$160.40–$165.742
MN$161.221
MO$157.26–$161.493
MS$155.961
MT$163.651
NC$158.691
ND$160.491
NE$156.841
NH$164.861
NJ$172.88–$178.412
NM$160.971
NV$162.821
NY$159.81–$184.055
OH$159.761
OK$157.611
OR$161.90–$169.142
PA$159.65–$168.592
PR$164.081
RI$166.731
SC$159.411
SD$160.121
TN$157.061
TX$159.20–$166.268
UT$160.391
VA$161.32–$178.452
VI$164.081
VT$160.571
WA$166.26–$178.642
WI$158.061
WV$160.021
WY$162.271

Explore G2004 on the national rate map →

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 G2004 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$184.21

$167.46 × 110% = $184.21

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.

Compare your contract offer →

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 G2004 in Merced.

PPRRVU2026_Oct_nonQPP.csv

15,412

Code
G2004
Physician work
3.38
Practice expense
1.36
Malpractice
0.16

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for G2004 in Merced
ComponentRVULocality factorAdjusted
Physician work3.38× 1.0173.4375
Practice expense1.36× 1.0961.4906
Malpractice0.16× 0.5360.0858
Total RVUs5.0138
Conversion factor× 33.4009

Office / nonfacility rate, Merced$167.46

Open G2004 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.381.017
Practice expense1.361.096
Malpractice0.160.536

(3.38 × 1.017 + 1.36 × 1.096 + 0.16 × 0.536) × $33.4009 = $167.46

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

G2004 · Office / nonfacility

$167.46

Effective 2026-10-01

The base rate is $11.27 higher than on 2025-10-01, moving from $156.19 to $167.46 (7.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $156.19changed to$167.46

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.20 changed to 1.36
    • 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.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $156.19

    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 fromOffice / nonfacilityFacilityCMS release
2026-10-01$167.46Not available in this settingRVU26D
2026-07-01$167.46Not available in this settingRVU26C
2026-04-01$167.46Not available in this settingRVU26B
2026-01-01$167.46Not available in this settingRVU26A
2025-10-01$156.19Not available in this settingRVU25D
2025-07-01$156.19Not available in this settingRVU25C
2025-04-01$156.19Not available in this settingRVU25B
2025-01-01$156.19Not available in this settingRVU25A

G2004 billing questions

When should G2004 be selected instead of G2009?

Use G2004 for a qualifying new patient and G2009 for an established patient when the post-discharge home visit is documented at the 60-minute level.

How does G2004 differ from G2003 and G2005?

Those codes are the neighboring new-patient post-discharge home-visit levels: G2003 is 45 minutes and G2005 is 75 minutes. Select the level supported by the documented service time.

What documentation supports G2004?

Record that the visit occurred at the beneficiary’s home after discharge, the beneficiary’s new-patient status, the time supporting the 60-minute level, and the assessment and plan.

Can G2004 be reported for a clinic follow-up?

No. G2004 identifies a post-discharge home visit; a clinic encounter is not the home service represented by this code.

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.

RVUs for G2004PPRRVU2026_Oct_nonQPP.csv, line 15,412 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)