G9679
No office rateAcute care pneumonia
G9679 is identified for acute care involving pneumonia. G9685 is labeled for acute nursing facility care and does not name a diagnosis.
On this page
CMS RVU26D · Effective 2026-10-01
G9685 Nursing facility care Medicare reimbursement rates in Colorado
Identifies acute nursing facility care in CMS coding; the descriptor distinguishes this setting from acute care reported by diagnosis. Compare G9685 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for G9685 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$157.86
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$157.86
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Nursing facility care
About G9685: Acute nursing facility care
Identifies acute nursing facility care in CMS coding; the descriptor distinguishes this setting from acute care reported by diagnosis.
G9685 is labeled for acute nursing facility care. The CMS descriptor identifies the care setting and acute-care context, but does not specify a particular diagnosis, visit level, procedure, or clinical threshold. The code is relevant to care furnished in a nursing facility rather than an acute-care hospital. The supplied CMS facts do not identify a particular provider type or give clinical criteria that would further define the service.
For code selection, documentation should support that the care was acute and furnished in a nursing facility, including the encounter date and the clinical work performed. The CMS fee schedule file assigns work, practice expense, and malpractice relative value units to G9685; the file does not provide a separate add-on, global-period, component, or multiple-procedure instruction for this code. CMS reported no office or facility services for G9685 in 2024. That utilization figure describes the reported data, not a clinical selection criterion.
Where the value comes from
- Work RVU3.50 · 75%
- Practice expense (office) RVU0.90 · 19%
- Malpractice RVU0.29 · 6%
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.
G9685 compared with similar codes
Office rates for Colorado, from the same CMS release.
G9680
No office rateAcute care congestive heart
G9680 is identified for acute care involving congestive heart failure. G9685 distinguishes acute nursing facility care without specifying a condition.
G9684
No office rateAcute care urinary tract inf
G9684 is identified for acute care involving urinary tract infection. G9685 identifies the nursing facility care context rather than that diagnosis.
Compare G9685 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
$157.86
Facility
$157.86
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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 G9685 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
16,101
- Code
- G9685
- Physician work
- 3.50
- Practice expense
- 0.90
- Malpractice
- 0.29
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.50 | × 1.012 | 3.5420 |
| Practice expense | 0.90 | × 1.064 | 0.9576 |
| Malpractice | 0.29 | × 0.781 | 0.2265 |
| Total RVUs | 4.7261 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$157.86
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.5 | 1.012 |
| Practice expense | 0.9 | 1.064 |
| Malpractice | 0.29 | 0.781 |
(3.5 × 1.012 + 0.9 × 1.064 + 0.29 × 0.781) × $33.4009 = $157.86
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.5 | 1.012 |
| Practice expense | 0.9 | 1.064 |
| Malpractice | 0.29 | 0.781 |
(3.5 × 1.012 + 0.9 × 1.064 + 0.29 × 0.781) × $33.4009 = $157.86
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.
G9685 billing questions
How does G9685 differ from an acute-care hospital code?
G9685 is labeled for acute nursing facility care. The nearby G9679–G9684 codes identify acute care by condition, such as pneumonia or urinary tract infection.
Does the descriptor identify a specific diagnosis or visit level?
No. The CMS descriptor identifies acute nursing facility care but does not state a diagnosis, visit level, or clinical threshold.
What documentation supports reporting G9685?
The record should establish that the care was acute and occurred in a nursing facility, and describe the date and clinical work performed.
Does G9685 have a professional or technical component?
The supplied CMS facts assign work, practice expense, and malpractice relative value units, but do not identify separate professional and technical components.
Does the CMS file show services reported for G9685 in 2024?
The supplied data show zero office services and zero facility services for 2024.
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.
16,098G9682,,Acute care skin infection,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
16,099G9683,,Acute fluid/electro disorder,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
16,100G9684,,Acute care urinary tract inf,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
16,101G9685,,Acute nursing facility care,A,,3.50,0.90,,0.90,,0.29,4.69,4.69,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
16,102G9687,,Hospice anytime msmt per,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
16,103G9688,,Pt w/hosp anytime msmt per,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
16,104G9689,,Inpt elect carotid intervent,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899