Arizona · 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 in Arizona

Arizona Medicare Avg
$23.46
3% below national avg
National Medicare Avg
$24.10
All states combined
Billed Charge (AZ)
$85.53
What providers submit
Est. Commercial (AZ)
$68.28
National avg: $69.06
Est. Cash / Self-Pay (AZ)
$45.98
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

22.9K
Services in AZ
982
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Arizona

Provider Medicare Services
Gupta, Ruchir MD $24.41 2.9K
Del Sordi-Staats, Susan D.O. $24.49 326
Patel, Ruchir M.D. $24.05 278
Bajaj, Aung M.D $23.89 274
Salins, Naomi MD $24.38 263
Rosenberg, Richard M.D. $23.16 259
Hetrick, Stuart D.O. $24.20 214
Grado, Gordon M.D. $23.26 158
Chan, Justine M.D. $24.34 148
Evidente, Virgilio M.D. $24.72 143
Mcfarlane, Matthew M.D., PH.D. $24.99 142
Sindhu, Hemant MD $24.94 118

Arizona Pricing in Context

In Arizona, CPT code 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) carries an average Medicare payment of $23.46 — 3% below the national benchmark of $24.10. 982 providers across the state submitted claims for this procedure in 2023, performing 22.9K total services. Individual payments in AZ 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 Arizona is $85.53, 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 Arizona sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Temporary Procedures procedures, the estimated commercial insurance price in Arizona lands near $68.28, with self-pay cash prices typically around $45.98. 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 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 cost in Arizona?

The average Medicare payment for 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 in Arizona is $23.46, which is 3% below the national average of $24.10. Providers in AZ typically bill $85.53 for this procedure.

What does 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 cost with insurance in Arizona?

With commercial insurance in Arizona, 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 costs an estimated $68.28. Without insurance, the estimated cash price is $45.98. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform 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 in Arizona?

982 providers in Arizona billed Medicare for 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 in 2023, performing 22.9K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is 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 cheaper in Arizona than the national average?

Yes — 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 costs 3% below the national average in Arizona. The state average Medicare payment is $23.46 compared to $24.10 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial