HCPCS G0559: Unrelated follow-upMedicare rate & RVUs in Illinois
G0559 is an add-on for an unrelated evaluation and management visit furnished by a different practitioner during a surgical procedure’s global period.
Medicare pays $9.96–$11.04 for G0559 in the office in Illinois, from Rest Of Illinois to Chicago. Which amount applies depends on the service address.
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 9 sections
What G0559 covers
G0559 accounts for an evaluation and management visit for a problem unrelated to a recent operation, when the visit is furnished during that operation’s global period by a practitioner other than the one who performed the procedure. A typical setting is an office or outpatient encounter with a primary care clinician or specialist addressing a separate health concern while the patient is still in the global period for surgery. It is not for the surgeon’s routine postoperative check or management of the operated site.
Report G0559 only with the primary E/M service; it is not a stand-alone visit code. Select the E/M code based on the documented service and applicable level-selection rules. The record should support the unrelated problem, the work performed, and the visit’s connection to a practitioner other than the operating practitioner. CMS treats G0559 as an add-on paid within the primary procedure’s global period, so submit it with the qualifying E/M service during that 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.
Where G0559 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$9.96 to $11.04
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $11.04 | $9.36 |
| East St. Louis | $10.44 | $8.90 |
| Rest Of Illinois | $9.96 | $8.44 |
| Suburban Chicago | $10.59 | $8.87 |
How the G0559 rate is calculated
Each of G0559’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 · G0559
RVUs × geographic indexes × conversion factor
Work0.16
0.16 RVUs× 1.000 GPCI
Practice expense0.10
0.10 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
0.2900
Conversion factor
$33.4009
Medicare rate
$9.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G0559
The CMS indicators that decide how G0559 is paid alongside other services.
CMS payment indicators · G0559
Unrelated follow-up
| 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. |
G0559 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 99024Postop follow-up visit
- 99024 represents routine postoperative follow-up. G0559 accompanies an E/M visit for an unrelated problem furnished by another practitioner during the global period.
- 99213Office visit
- 99213 describes the primary established-patient E/M service. G0559 is an add-on and does not replace the E/M code.
- G2211Visit complexity add-on
- G2211 reflects visit complexity associated with ongoing care relationships or serious conditions. G0559 addresses an unrelated E/M visit by another practitioner during a surgical global period.
G0559 billing questions
When is G0559 appropriate?
Use it for an E/M visit addressing a problem unrelated to the surgery, furnished during that procedure’s global period by a practitioner other than the operating practitioner.
Can G0559 be submitted by itself?
No. It is an add-on code and must be reported with the primary E/M service.
Does it apply to a routine postoperative check?
No. Routine recovery checks and care related to the operation are part of postoperative care, not an unrelated visit represented by G0559.
What should the medical record show?
Document the separate problem evaluated, the E/M work performed, and that the visit occurred during the surgical global period with a practitioner other than the operating practitioner.
How is the E/M level selected?
Choose the primary E/M code using the documentation and the applicable office or outpatient E/M selection rules. G0559 does not replace or determine that 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 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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