Medicare Primary Care Fee Schedule (Free CSV and PDF)

This is a free Medicare primary care fee schedule: new and established office visits, the G2211 and G2212 add-ons, the annual wellness visit and other preventive services, care management, and the office procedures a primary care practice bills most days, each with its Medicare Physician Fee Schedule allowed amount in the office and in a facility. Leave the ZIP blank for national amounts or enter yours for your payment locality, choose a date of service, and download the sheet as a CSV or a print-ready PDF. No signup.

Each amount is for one service: what Medicare allows for that code before the deductible and coinsurance. It isn't a visit total, the patient's bill or a commercial rate. A visit that pairs an E/M with G2211 or a same-day procedure is priced line by line, and some combinations don't pay at all.

How to read the primary care fee sheet

Each row is a code, our plain-English name for it, an office amount and a facility amount. The office (non-facility) rate is higher because it includes the cost of running the practice. The facility rate applies when the place of service is a hospital outpatient department, including a provider-based clinic, or another facility that Medicare pays separately for overhead. Switch the place of service below to see the gap on a mid-level visit:

Leave the ZIP blank for national amounts. Enter your ZIP and the sheet reprices every row for your Medicare payment locality. The date picks the CMS release in effect on that day, which matters in January, when the conversion factor changes, and after quarterly corrections. The CSV and PDF record the ZIP, date and release on the sheet itself. More on the split: facility vs non-facility rates.

Why some codes show a status instead of a price

A row with a note instead of an amount means CMS doesn't pay that code on the physician fee schedule. Two rows in this preset are there for exactly that reason:

• 99417 isn't valid for Medicare. Medicare uses G2212 for prolonged office time instead.
• 36415, routine venipuncture, isn't on the physician fee schedule at all. Medicare pays it on the Clinical Laboratory Fee Schedule, so look there for its amount.

Using the % of Medicare column

Enter a percentage in Your rate, % of Medicare to add a column at that share of each office amount. A Medicare Advantage or commercial contract written as 105% of Medicare becomes a dollar schedule in one step. For a real contract comparison weighted by how often you bill each code, use the contract check.

What's on the sheet and why

The preset is an editorial selection, not a list of the most-billed codes. We chose the services a Medicare primary care practice needs to price and explain, grouped as you'd read them:

Search for any other code under the table to add it, remove what you don't bill, or reset to the original list.

Primary care billing traps

Office visit levels

Office visits are leveled by medical decision making or by total time on the date of the encounter. Here are the established-patient levels with the minimum total time for each, and how the amounts and work RVUs climb:

G2211 rides on the visit, with one big exception

G2211 adds payment to an office or home E/M when you're the patient's continuing focal point for care or manage a single serious or complex condition over time. It's one unit on the same claim as the visit. Medicare denies it when the E/M has modifier 25 for a same-day procedure, such as a joint injection (20610), but pays it when modifier 25 is for an annual wellness visit, a vaccine administration or another Part B preventive service. The G2211 guide walks through who can bill it.

G2212, not 99417, for prolonged time

Medicare doesn't accept prolonged office code 99417. It pays G2212 for each full 15 minutes beyond the highest-level visit, and its count starts later than the rules for 99417: First Coast, a Medicare contractor, lists one unit of G2212 at 89–103 total minutes with 99205 and at 69–83 minutes with 99215. A 75-minute new-patient visit is prolonged under the rules for 99417 but not under Medicare's. Use 99417 for commercial payers that accept it, and G2212 for Medicare.

Annual wellness visits aren't physicals

The AWV is billed with G0438 for the patient's first one ever and G0439 every 12 months after that; the one-time Welcome to Medicare exam is G0402. A problem-oriented visit the same day is a separate E/M with modifier 25, and advance care planning (99497) can be added. See the annual wellness visit guide for timing rules and denials.

Need a sheet built around your codes and contracts?

The free sheet starts from our list. If you want one built from your own code list, at your locality, with your payers' rates or percentages next to Medicare's, you can request a custom fee sheet. Share your codes, location and the dates you need; we confirm the details and prepare it. It's a request we handle directly, not an upload or an automated contract analysis.

Sources: CMS Medicare Physician Fee Schedule relative value files (release shown on the sheet), including status indicators for 99417 (I) and 36415 (X); First Coast Service Options, "Prolonged physician services: office and other outpatient visits" (October 28, 2024); CMS G2211 FAQ and MLN Matters MM13272 and MM13473. Verified October 6, 2026.

FAQ

What is the Medicare physician fee schedule?

It's the list of amounts Medicare Part B allows for physician and other practitioner services. CMS sets relative value units for each code, adjusts them for each payment locality and multiplies by a yearly conversion factor. The sheet above shows the result for primary care codes at your ZIP.

How can I find the Medicare physician fee schedule for my area?

Enter your ZIP in the sheet. It finds your Medicare payment locality and reprices every code. The same data is on each code page and in CMS's lookup tool.

How can I download the 2026 Medicare physician fee schedule?

CMS publishes the full schedule as relative value and GPCI files that need assembling. For primary care codes, download this sheet as a CSV or PDF; it's already priced for your locality and date, with the release label.

Does Medicare pay 99417?

No. Medicare lists 99417 as not valid and pays G2212 for prolonged office and outpatient time, starting at a later minute count than code 99417.

Does Medicare pay 20% or 80%?

Medicare pays 80% of the allowed amount after the Part B deductible, and the patient or their supplemental coverage owes the other 20%. Some preventive services, including the annual wellness visit, have no coinsurance or deductible when you accept assignment. The sheet shows the full allowed amount.

Can G2211 be billed with an annual wellness visit?

Yes, since January 1, 2025. G2211 goes with the E/M, and modifier 25 on that E/M for a same-day AWV doesn't block it. It still denies when modifier 25 is there for a procedure.

Related: G2211 guide, annual wellness visit, contract check, and the RVU calculator.