HCPCS G2211
Bundled / not separately paid
G2211 · PFS Q4 2021 · Historical
No national PFS rate in Q4 2021
Status B is not separately payable under the PFS.
HCPCS G2211 has no published national rate. It carries status B (bundled) in the Q4 2021 release. Medicare folds payment for this code into the service it is incident to, never onto its own line. The blank amount means unpriced, not $0.
PFS status evidence
Inspect PFS status evidence
- Code
- G2211
- Release
- Q4 2021, revision 1
- Result
- Bundled / not separately paid
Citations
-
Shows this code’s PFS status (B). Result: Bundled / not separately paid.
Physician relative value file (PPRRVU)Q4 2021 · revision 1
Latest revision of this release
Release period: October 1 – December 31, 2021
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
Record details
PPRRVU21_OCT.csv in rvu21d.zip (row 1,858)- hcpcs (col 1)
- G2211
- modifier (col 2)
- blank
- status_code (col 4)
- B
SHA-256: f1972bd23bdc51795ceba7d536bb413a0ba0b47fad8c2ed594e7ee7799877297
Why is there no national PFS amount for G2211?
Its status indicator is B (bundled). Medicare folds payment for this code into the service it is incident to, never onto its own line. Status B is not separately payable under the PFS.
About this code
Complex e/m visit add on
Payment considerations Copy link
Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.
Other payment indicators (10)
Facility/non-facility: Not determined, Professional/technical component: Does not apply, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Not determined, NCCI same-day edits: Not determined, MUE behavior: Not determined, Other fee-schedule routing: Does not apply, Contractor pricing: Does not apply.
Why would a Medicare claim for G2211 be denied or paid less?
These come from CMS indicators on this page, not general billing advice.
- Its status indicator is B (bundled)—Medicare folds payment for this code into the service it is incident to, never onto its own line. See status indicators
Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.
Payment review for G2211 Copy link
G2211 is a separate line, not a percentage built into the office visit. Check the base visit and the add-on separately, using the rules and fee-schedule release in effect on the date of service.
What to check
- Confirm the base visit and G2211 were both priced with the same locality, setting, and release.
- Check the modifier 25 and preventive-service rules for the date of service; they changed after G2211 started paying separately.
- Whether the ongoing care relationship qualifies is a separate question from how much Medicare pays once the add-on applies.
Codes to compare
National Q4 2021 amounts at GPCI 1.000. A blank means this schedule does not publish a payable PFS amount.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS FAQs about E/M visit complexity add-on HCPCS code G2211; CMS MLN Matters MM13473: how to use G2211.
Which billing rules and modifiers apply? Copy link
Global period: what G2211's fee already covers Copy link
This code is always billed alongside another service and carries no follow-up period of its own. The primary procedure's global period governs; this indicator does not determine whether either line is payable.
Can you bill it with another code? Copy link
Check a pair of codes Copy link
Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit for the pair.
How has it changed? Copy link
Rate history by release Copy link
National Office (non-facility) amount for G2211 across quarterly releases. +8.3% increase since Q1 2024 · peak $17.37 in Q1 2026
| Release | Status | Office | Facility |
|---|---|---|---|
| Q4 2026 takes effect Oct 1, 2026 | A | $17.37 (0.0% no change ) | $14.36 (0.0% no change ) |
| Q3 2026 Jul 1, 2026 – Sep 30, 2026 | A | $17.37 (0.0% no change ) | $14.36 (0.0% no change ) |
| Q2 2026 Apr 1, 2026 – Jun 30, 2026 | A | $17.37 (0.0% no change ) | $14.36 (0.0% no change ) |
| Q1 2026 Jan 1, 2026 – Mar 31, 2026 | A | $17.37 (+11.8% increase ) | $14.36 (-7.5% decrease ) |
| Q4 2025 Oct 1, 2025 – Dec 31, 2025 | A | $15.53 (0.0% no change ) | $15.53 (0.0% no change ) |
| Q3 2025 Jul 1, 2025 – Sep 30, 2025 | A | $15.53 (0.0% no change ) | $15.53 (0.0% no change ) |
| Q2 2025 Apr 1, 2025 – Jun 30, 2025 | A | $15.53 (0.0% no change ) | $15.53 (0.0% no change ) |
| Q1 2025 Jan 1, 2025 – Mar 31, 2025 | A | $15.53 (-4.8% decrease ) | $15.53 (-4.8% decrease ) |
| Q4 2024 Oct 1, 2024 – Dec 31, 2024 | A | $16.31 (0.0% no change ) | $16.31 (0.0% no change ) |
| Q3 2024 Jul 1, 2024 – Sep 30, 2024 | A | $16.31 (0.0% no change ) | $16.31 (0.0% no change ) |
| Q2 2024 Apr 1, 2024 – Jun 30, 2024 | A | $16.31 (0.0% no change ) | $16.31 (0.0% no change ) |
| Q1 2024 Mar 9, 2024 – Mar 31, 2024 | A | $16.31 (+1.7% increase ) | $16.31 (+1.7% increase ) |
| Q1 2024 Jan 1, 2024 – Mar 8, 2024 | A | $16.04 | $16.04 |
| Q4 2023 Oct 1, 2023 – Dec 31, 2023 | B | — | — |
| Q3 2023 Jul 1, 2023 – Sep 30, 2023 | B | — | — |
| Q2 2023 Apr 1, 2023 – Jun 30, 2023 | B | — | — |
| Q1 2023 Jan 1, 2023 – Mar 31, 2023 | B | — | — |
| Q4 2022 Oct 1, 2022 – Dec 31, 2022 | B | — | — |
| Q3 2022 Jul 1, 2022 – Sep 30, 2022 | B | — | — |
| Q2 2022 Apr 1, 2022 – Jun 30, 2022 | B | — | — |
| Q1 2022 Jan 1, 2022 – Mar 31, 2022 | B | — | — |
| Q4 2021 Oct 1, 2021 – Dec 31, 2021 | B | — | — |
| Q3 2021 Jul 1, 2021 – Sep 30, 2021 | B | — | — |
| Q2 2021 Apr 1, 2021 – Jun 30, 2021 | B | — | — |
Code and billing changes Copy link
The most relevant verified changes to this code and related Medicare billing policy.
Planned Full interactive timeline, two-date comparison, and an exportable citation packet.
Effective Jan 1, 2021
G2211 became reportable, but remained bundled
For qualifying longitudinal-care visits, G2211 could be reported with any new- or established-patient office/outpatient visit level, 99202-99205 or 99211-99215. Medicare assigned it bundled status, so it did not produce separate payment.
When does this rate change?
CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.
The G2211 rate last moved in Q1 2026. See its rate history.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
Usage and related codes Copy link
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Source & method
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This page uses CMS's Medicare Physician Fee Schedule Q4 2021 release (effective October 2021). National baselines use GPCI 1.000 and exclude sequestration. Whether a national amount exists depends on the status and CMS’s payment instructions; blank RVUs are never treated as zero. Past releases are never edited, so these sources stay valid after CMS publishes a newer one. CMS owns the code description shown for HCPCS Level II codes. Our methodology explains sourcing, parsing, versioning, and how we cross-check claims before we publish them.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
The citation names the release, so anyone can check it even after CMS publishes a newer one.
HCPCS G2211 National PFS baseline: No national PFS rate (Q4 2021; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/hcpcs/G2211/2021/D