Medicare Reimbursement for G2087 – Off Base Opioid Tx, 60 M

HCPCS code G2087 describes an office-based opioid treatment service reported in 60-minute increments. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount nationally and by locality, with separate figures for non-facility (e.g., office) and facility (e.g., hospital outpatient) settings.

Medicare allowed amount (2026)

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 2 units per patient per day — Date of Service Edit: Clinical. Units above the MUE are denied; some MUEs can be exceeded only with appropriate documentation and modifiers where policy allows.

How the amount is calculated

Medicare's PFS amount is built from three Relative Value Units (RVUs) — work, practice expense, and malpractice — that reflect the physician effort, overhead cost, and liability risk associated with the service. Each RVU component is adjusted by locality-specific Geographic Practice Cost Indices (GPCIs) to account for regional cost differences, then the adjusted RVUs are summed and multiplied by the annual conversion factor to produce a dollar amount. Non-facility and facility rates differ mainly in the practice-expense RVU, since overhead costs are typically lower when the service is furnished in a facility setting (e.g., a hospital) versus billed under a physician's own office. The national figures shown use national GPCI averages; actual locality-specific amounts will vary.

RVUs — work 8.19, practice expense 4.53 (non-facility) / 1.59 (facility), malpractice 0.55 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

• This is an estimate only, not a guarantee of payment.
• Medicare typically pays 80% of the allowed amount after the annual Part B deductible is met; the patient or secondary insurer is responsible for the remainder.
• Actual payment can be affected by modifiers, place of service, sequestration, MAC-specific edits, and annual budget-neutrality adjustments to RVUs or the conversion factor.
• Always confirm the exact allowed amount and coverage rules with your local Medicare Administrative Contractor (MAC).

Frequently asked

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Estimated Medicare Physician Fee Schedule amount. Medicare generally pays 80% after the deductible; actual amounts vary by locality, modifiers, sequestration, and annual updates. Verify with your MAC.