Prolonged nursing facility 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 the physician or qualifi
Medicare pricing data for 5,540 providers across 51 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Prolonged nursing facility 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 the physician or qualifi (HCPCS code G0317) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $27.29, but hospitals typically charge $69.51 — a 2.5x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $27.29, your out-of-pocket cost would be approximately $5.46. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $21.61 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $40 | $200 | 12 | 809 | +46.1% |
| California | $31 | $90 | 228 | 14,048 | +15.1% |
| Hawaii | $31 | $75 | 26 | 689 | +12.1% |
| Maryland | $30 | $69 | 162 | 4,194 | +8.8% |
| District of Columbia | $29 | $43 | 7 | 63 | +6.9% |
| New Jersey | $29 | $78 | 240 | 6,520 | +6.4% |
| Idaho | $29 | $123 | 25 | 1,125 | +4.9% |
| West Virginia | $29 | $48 | 19 | 135 | +4.6% |
| Georgia | $29 | $76 | 55 | 960 | +4.5% |
| Michigan | $28 | $139 | 136 | 4,336 | +4.1% |
| Virginia | $28 | $60 | 179 | 4,429 | +2.7% |
| Maine | $28 | $61 | 62 | 758 | +2.6% |
| Colorado | $28 | $89 | 141 | 3,329 | +2.5% |
| Missouri | $28 | $86 | 144 | 2,655 | +2.2% |
| Vermont | $28 | $97 | 35 | 541 | +2.2% |
| Pennsylvania | $28 | $57 | 287 | 5,013 | +2.1% |
| Utah | $28 | $133 | 53 | 1,686 | +1.6% |
| Washington | $28 | $76 | 179 | 6,589 | +1.6% |
| New Mexico | $28 | $69 | 49 | 937 | +0.8% |
| Montana | $27 | $90 | 40 | 1,035 | +0.6% |
| Connecticut | $27 | $76 | 134 | 3,565 | +0.5% |
| Florida | $27 | $51 | 245 | 21,693 | +0.1% |
| Rhode Island | $27 | $70 | 19 | 236 | -0.2% |
| New York | $27 | $61 | 175 | 7,815 | -0.4% |
| Illinois | $27 | $50 | 279 | 10,976 | -1.1% |
| North Carolina | $27 | $59 | 185 | 6,828 | -1.5% |
| New Hampshire | $27 | $51 | 41 | 327 | -1.5% |
| Arizona | $27 | $44 | 38 | 1,034 | -2.5% |
| Ohio | $26 | $111 | 229 | 3,512 | -3.0% |
| Minnesota | $26 | $88 | 164 | 1,856 | -3.6% |
| Delaware | $26 | $52 | 7 | 95 | -3.7% |
| Kansas | $26 | $62 | 79 | 2,686 | -3.7% |
| Oklahoma | $26 | $70 | 25 | 1,103 | -3.7% |
| South Carolina | $26 | $48 | 262 | 15,002 | -4.1% |
| Oregon | $26 | $70 | 56 | 1,346 | -4.6% |
| Massachusetts | $26 | $66 | 204 | 4,045 | -4.7% |
| South Dakota | $26 | $37 | 4 | 49 | -4.7% |
| Texas | $26 | $59 | 393 | 10,951 | -4.8% |
| Nevada | $26 | $57 | 47 | 8,242 | -4.8% |
| Kentucky | $26 | $74 | 44 | 733 | -5.0% |
| Wyoming | $26 | $66 | 26 | 203 | -5.4% |
| North Dakota | $26 | $75 | 16 | 166 | -5.4% |
| Indiana | $26 | $81 | 116 | 1,378 | -5.6% |
| Louisiana | $26 | $51 | 105 | 1,986 | -6.4% |
| Alabama | $25 | $50 | 39 | 975 | -7.9% |
| Tennessee | $25 | $79 | 91 | 5,453 | -7.9% |
| Wisconsin | $25 | $114 | 151 | 4,770 | -8.8% |
| Iowa | $25 | $57 | 103 | 1,679 | -9.0% |
| Nebraska | $25 | $64 | 78 | 2,560 | -9.1% |
| Arkansas | $24 | $57 | 79 | 2,622 | -10.4% |
| Mississippi | $24 | $51 | 10 | 171 | -10.5% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber