HCPCS G0180: what Medicare pays in 2026

Service defined by CMS CMS description: Md certification hha patient

Medicare's 2026 national amount for G0180 is $56.78 when a doctor's office or clinic bills it. Across Medicare's 109 payment localities the office amount runs from $51.26 in Arkansas to $73.16 in San Jose-Sunnyvale-Santa Clara (San Benito County), CA.

Medicare amounts for G0180 in 2026

Doctor's office or clinic, national: $56.78
Hospital outpatient status M: not billable by hospitals

What providers charged Medicare for G0180 in 2024

From CMS's national utilization file (the most recent full year published). The charge is the provider's list price, the same kind of figure an uninsured patient is usually billed.

Setting	Services	Average charge	Medicare allowed	Charge vs allowed
In an office or other non-facility setting	843,504	$126.11	$51.94	2.4×
In a facility setting	78,042	$177.71	$52.11	3.4×

How Medicare builds the G0180 amount

Each physician fee schedule amount is three relative value units (RVUs), each multiplied by the locality's cost index, added up and multiplied by the 2026 conversion factor of $33.4009.

Work RVU: 0.65
Practice expense RVU, office: 1.00
Malpractice RVU: 0.05

G0180 in every Medicare locality

The office amount is lowest in Arkansas and highest in San Jose-Sunnyvale-Santa Clara (San Benito County), CA.

State	Locality	Office	Facility
AK	Alaska	$69.06	none
AL	Alabama	$51.88	none
AR	Arkansas	$51.26	none
AZ	Arizona	$55.51	none
CA	Bakersfield	$59.75	none
CA	Chico	$59.58	none
CA	El Centro	$59.59	none
CA	Fresno	$59.58	none
CA	Hanford-Corcoran	$59.58	none
CA	Los Angeles-Long Beach-Anaheim (Los Angeles/Orange County)	$63.22	none
CA	Madera	$59.58	none
CA	Merced	$59.58	none
CA	Modesto	$59.58	none
CA	Napa	$67.95	none
CA	Oxnard-Thousand Oaks-Ventura	$62.84	none
CA	Redding	$59.58	none
CA	Rest of California	$59.58	none
CA	Riverside-San Bernardino-Ontario	$60.13	none
CA	Sacramento-Roseville-Folsom	$62.23	none
CA	Salinas	$61.99	none
CA	San Diego-Chula Vista-Carlsbad	$63.21	none
CA	San Francisco-Oakland-Berkeley (Marin County)	$71.63	none
CA	San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County)	$71.58	none
CA	San Jose-Sunnyvale-Santa Clara (San Benito County)	$73.16	none
CA	San Jose-Sunnyvale-Santa Clara (Santa Clara County)	$72.93	none
CA	San Luis Obispo-Paso Robles	$61.02	none
CA	Santa Cruz-Watsonville	$63.64	none
CA	Santa Maria-Santa Barbara	$62.16	none
CA	Santa Rosa-Petaluma	$64.27	none
CA	Stockton	$59.58	none
CA	Vallejo	$67.87	none
CA	Visalia	$59.58	none
CA	Yuba City	$59.58	none
CO	Colorado	$58.81	none
CT	Connecticut	$60.14	none
DC	DC + MD/VA Suburbs	$64.09	none
DE	Delaware	$56.32	none
FL	Fort Lauderdale	$58.57	none
FL	Miami	$60.70	none
FL	Rest of Florida	$56.15	none
GA	Atlanta	$57.72	none
GA	Rest of Georgia	$53.49	none
HI	Hawaii, Guam	$60.65	none
IA	Iowa	$52.94	none
ID	Idaho	$53.23	none
IL	Chicago	$59.26	none
IL	East St. Louis	$55.80	none
IL	Rest of Illinois	$54.82	none
IL	Suburban Chicago	$59.12	none
IN	Indiana	$53.48	none
KS	Kansas	$52.75	none
KY	Kentucky	$52.93	none
LA	New Orleans	$55.04	none
LA	Rest of Louisiana	$52.87	none
MA	Metropolitan Boston	$63.97	none
MA	Rest of Massachusetts	$58.56	none
MD	Baltimore/Surrounding Counties	$59.96	none
MD	Rest of Maryland	$57.26	none
ME	Rest of Maine	$53.48	none
ME	Southern Maine	$55.86	none
MI	Detroit	$56.76	none
MI	Rest of Michigan	$54.09	none
MN	Minnesota	$56.57	none
MO	Metropolitan Kansas City	$54.71	none
MO	Metropolitan St. Louis	$55.18	none
MO	Rest of Missouri	$52.13	none
MS	Mississippi	$51.70	none
MT	Montana	$56.78	none
NC	North Carolina	$53.94	none
ND	North Dakota	$55.79	none
NE	Nebraska	$53.17	none
NH	New Hampshire	$57.94	none
NJ	Northern NJ	$63.61	none
NJ	Rest of New Jersey	$60.88	none
NM	New Mexico	$54.34	none
NV	Nevada	$56.54	none
NY	Manhattan	$64.56	none
NY	NYC Suburbs/Long Island	$65.92	none
NY	Poughkeepsie/Northern NYC Suburbs	$61.28	none
NY	Queens	$64.99	none
NY	Rest of New York	$54.62	none
OH	Ohio	$53.89	none
OK	Oklahoma	$52.84	none
OR	Portland	$60.41	none
OR	Rest of Oregon	$56.15	none
PA	Metropolitan Philadelphia	$58.86	none
PA	Rest of Pennsylvania	$53.95	none
PR	Puerto Rico	$57.12	none
RI	Rhode Island	$58.12	none
SC	South Carolina	$53.99	none
SD	South Dakota	$55.67	none
TN	Tennessee	$52.97	none
TX	Austin	$58.57	none
TX	Beaumont	$53.66	none
TX	Brazoria	$56.29	none
TX	Dallas	$56.61	none
TX	Fort Worth	$56.29	none
TX	Galveston	$56.43	none
TX	Houston	$57.35	none
TX	Rest of Texas	$54.92	none
UT	Utah	$54.61	none
VA	Virginia	$55.72	none
VI	Virgin Islands	$57.12	none
VT	Vermont	$55.62	none
WA	Rest of Washington	$58.43	none
WA	Seattle (King County)	$65.14	none
WI	Wisconsin	$54.22	none
WV	West Virginia	$53.13	none
WY	Wyoming	$56.35	none