G2211 on every eligible visit, honest level 4s, counseling minutes, and wellness visits done right: these are the most commonly missed, fully documented coding opportunities in office practice.
Primary care leaves more earned value uncaptured than any other setting, and almost all of it is documentation, not extra work. These five patterns account for most of it.
If you manage a patient longitudinally and they follow up with you, most office visits qualify for the visit complexity add-on G2211 at 0.33 wRVU. It costs one sentence. The arithmetic is why it leads this page: at a conservative ten eligible visits a day, G2211 alone adds roughly 750 wRVU a year; at a typical employer compensation rate of thirty to fifty dollars per wRVU that is roughly twenty two to thirty seven thousand dollars, for work you are already doing (the figure to use is your own contract's dollars per wRVU, not the Medicare conversion factor, which prices total RVUs with geographic adjustment, not work RVUs alone). The one common blocker: it is not paid when the visit carries modifier 25 for a same day minor procedure. The G2211 guide covers the exact sentence.
Two stable chronic conditions addressed, or one chronic condition not at goal, plus a prescription decision you made: that is a level 4 visit by the rules, and it describes an enormous share of primary care. The missing piece is almost always one sentence proving the second problem was addressed or the medication decision was deliberate. The 99213 versus 99214 guide shows the same visit written both ways.
Smoking cessation over 3 minutes is 99406 (0.24 wRVU), over 10 is 99407 (0.50). Obesity counseling at 15 or more face to face minutes is G0447. Advance care planning at 16 or more minutes is 99497. Each needs the exact minutes in the note, each stacks on top of the visit, and none can also serve as the diagnosis carrying your visit level.
A Medicare annual wellness visit and a problem visit can be reported the same day when the problem work is separately documented: the problem visit takes modifier 25, and by Medicare policy G2211 still pays on a wellness visit day. This combination is among the most underused in primary care.
Total time on the date of service, documented as an exact number of minutes, sets the level whenever it is higher than medical decision making: 30 to 39 minutes supports 99214 for an established patient, 40 or more supports 99215. Count everything that day except separately billed procedures, and name the components: reviewing records, counseling the patient or family, coordinating care, documenting.
To see all of this applied to your own work, paste a de-identified note into the E/M Assistant, or run five typical notes through the Five Note Audit for a personal estimate of your year. Both are free to try.