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Prolonged Office or Outpatient Visit, Additional 15 Minutes

New York rates for HCPCS G2212

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified health care professional, with or without direct patient contact (list separately in addition to CPT codes 99205, 99215, 99483 for office or other outpatient evaluation and management services.) (Do not report G2212 on the same date of service as codes 99358, 99359, 99415, 99416). (Do not report G2212 for any time unit less than 15 minutes)

Rates data updated July 2026.

Facilitymedian $29 · 10th–90th $25$1050%20%40%10th90th$29Professionalmedian $33 · 10th–90th $21$690%10%10th90th$33$1.0$5.0$20.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$26.30
Typical High
$104.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$31.62
Typical High
$60.26
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$25.70
Median
$52.48
Typical High
$158.49
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$33.11
Typical High
$47.86
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$21.38
Typical High
$48.98
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$46.77
Cigna
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$38.02
Typical High
$38.02
Cigna
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$23.44
Median
$23.99
Typical High
$97.72
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$48.98
Typical High
$69.18
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$36.31
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$35.48
Typical High
$70.79
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$38.90
Typical High
$54.95
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$46.77
Typical High
$79.43
Optum
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$38.02
Typical High
$51.29
United
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$34.67
Typical High
$36.31
United
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$47.86
Typical High
$194.98
Univera
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$32.36
Typical High
$33.88
Univera
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$35.48
Typical High
$66.07