Prolonged Hospital Inpatient Or Observation Care Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By Th in Washington
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Top Providers in Washington
| Provider | Medicare | Services |
|---|---|---|
| Wang, Jiakun MD | $24.32 | 150 |
| Aggarwal, Sunil MD, PHD | $25.38 | 59 |
Washington Pricing in Context
In Washington, CPT code G0316 (Prolonged Hospital Inpatient Or Observation Care Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By Th) carries an average Medicare payment of $24.08 — 4% above the national benchmark of $23.22. 870 providers across the state submitted claims for this procedure in 2023, performing 12.9K total services. Individual payments in WA ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.
The average billed charge in Washington is $90.17, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Washington sits above the national Medicare average, commercial rates in the state may also run higher than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Temporary Procedures procedures, the estimated commercial insurance price in Washington lands near $71.09, with self-pay cash prices typically around $47.48. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.
Frequently Asked Questions
How much does Prolonged Hospital Inpatient Or Observation Care Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By Th cost in Washington?
The average Medicare payment for Prolonged Hospital Inpatient Or Observation Care Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By Th in Washington is $24.08, which is 4% above the national average of $23.22. Providers in WA typically bill $90.17 for this procedure.
What does Prolonged Hospital Inpatient Or Observation Care Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By Th cost with insurance in Washington?
With commercial insurance in Washington, Prolonged Hospital Inpatient Or Observation Care Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By Th costs an estimated $71.09. Without insurance, the estimated cash price is $47.48. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Prolonged Hospital Inpatient Or Observation Care Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By Th in Washington?
870 providers in Washington billed Medicare for Prolonged Hospital Inpatient Or Observation Care Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By Th in 2023, performing 12.9K total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Prolonged Hospital Inpatient Or Observation Care Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By Th cheaper in Washington than the national average?
No — Prolonged Hospital Inpatient Or Observation Care Evaluation And Management Service(s) Beyond The Total Time For The Primary Service (when The Primary Service Has Been Selected Using Time On The Date Of The Primary Service); Each Additional 15 Minutes By Th costs 4% above the national average in Washington. The state average Medicare payment is $24.08 compared to $23.22 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.