HCPCS G0545: Inpatient complexityMedicare rate & RVUs in Oklahoma
Add-on for the added complexity of eligible inpatient or observation evaluation and management visits involving patients with serious or complex conditions.
Medicare pays $46.16 for G0545 in the office in Oklahoma (Oklahoma). 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 G0545 covers
G0545 recognizes the added work inherent in certain hospital-based evaluation and management visits for patients with serious or complex conditions. It is relevant to hospitalists, internists, and other clinicians managing these patients during an inpatient or observation stay. The primary service is the actual evaluation and management encounter; G0545 represents the additional complexity associated with that visit, not a separate patient encounter.
Report G0545 only with an eligible primary service, such as an initial or subsequent inpatient or observation care visit, when the visit meets the add-on’s requirements. Documentation should support the primary E/M service and describe the serious or complex condition and the work involved in managing it during the stay. CMS classifies G0545 as an add-on code: it is billed with a primary procedure and paid within that procedure’s global 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.
G0545 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $46.16 | $39.00 |
How the G0545 rate is calculated
Each of G0545’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 · G0545
RVUs × geographic indexes × conversion factor
Work0.89
0.89 RVUs× 1.000 GPCI
Practice expense0.49
0.49 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
1.4500
Conversion factor
$33.4009
Medicare rate
$48.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G0545
The CMS indicators that decide how G0545 is paid alongside other services.
CMS payment indicators · G0545
Inpatient complexity
| 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. |
G0545 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 99221Initial hospital care
- 99221 reports the initial inpatient or observation E/M service. G0545 is an add-on for qualifying added complexity and cannot replace the primary visit code.
- G2211Visit complexity add-on
- G2211 is a complexity add-on for qualifying office or outpatient E/M visits. G0545 is associated with inpatient or observation care.
- G0544Discharge follow-up
- G0544 describes post-discharge phone follow-up; G0545 is reported with an eligible inpatient or observation visit.
G0545 billing questions
Can G0545 be billed by itself?
No. It is an add-on code and must be reported with an eligible primary service.
How is G0545 different from the primary inpatient E/M code?
The primary E/M code reports the inpatient or observation encounter. G0545 captures added complexity associated with an eligible visit for a patient with a serious or complex condition.
What documentation supports G0545?
Document the primary inpatient or observation E/M service and the serious or complex condition and management work supporting the add-on.
Is G0545 a post-discharge telephone service?
No. G0545 is associated with an inpatient or observation visit. G0544 describes a post-discharge phone follow-up service.
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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