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#382 of 11K

G2212

Prolonged office/outpatient E/M, each additional 15 min

Prolonged office/outpatient E/M, each additional 15 min is the #382 most-billed Medicaid procedure code, with $289.9M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $72.96. Costs vary widely — the 90th percentile is $504.85 per claim, 6.9× the median.

Total Paid

$289.9M

0.03% of all spending

Total Claims

1.1M

Providers

747

Avg Cost/Claim

$273

National Cost Distribution

How much do providers bill per claim for G2212? Based on 675 providers billing this code nationally.

Median

$72.96

Average

$192.33

Std Dev

$214.11

Max

$1,227.20

Percentile Distribution (Cost per Claim)

p10
$5.27
p25
$21.62
Median
$72.96
p75
$339.25
p90
$504.85
p95
$591.79
p99
$808.07

50% of providers bill between $21.62 and $339.25 per claim for this code.

90% bill between $5.27 and $504.85.

Top 1% bill above $808.07.

About This Procedure

HCPCS code G2212 (Prolonged office/outpatient E/M, each additional 15 min) was billed by 747 providers across 1.1M claims, totaling $289.9M in Medicaid payments from 2018–2024. This code was used for 683K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$72.96

Providers Billing

675

National Spending

$289.9M

Avg/Median Ratio

2.64×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G2212

#ProviderTotal Paid
1Los Angeles County Department Of Mental Health

Los Angeles, CA · Clinic/Center, Mental Health (Including Community Mental Health Center)

$91.2M
2County Of Sacramento

Sacramento, CA · Clinic/Center Adult Mental Health

$17.2M
3County Of San Bernardino

San Bernardino, CA · Clinic/Center Rehabilitation Substance Use Disorder

$16.1M
4County Of Santa Clara

San Jose, CA · Community/Behavioral Health

$16.0M
5County Of Riverside

Riverside, CA · Community/Behavioral Health

$12.3M
6Contra Costa County

Martinez, CA · General Acute Care Hospital

$10.6M
7County Of Fresno

Fresno, CA · Clinic/Center Mental Health (Including Community Mental Health Center)

$10.0M
8City & County Of San Francisco

San Francisco, CA · Community/Behavioral Health

$6.9M
9County Of Kern

Bakersfield, CA · Clinic/Center, Adult Mental Health

$6.0M
10Alameda County Behavioral Health Care

Oakland, CA · Community/Behavioral Health

$5.6M
11County Of Tulare

Visalia, CA · Clinic/Center Public Health State or Local

$5.4M
12County Of San Diego

San Diego, CA · Public Health or Welfare

$4.7M
13County Of Solano

Fairfield, CA · Public Health or Welfare

$3.4M
14County Of Ventura

Oxnard, CA · Community/Behavioral Health

$2.9M
15County Of Stanislaus

Modesto, CA · Community/Behavioral Health

$2.6M
161750715801$1.9M
17Santa Barbara County Auditor

Santa Barbara, CA · Psychologist

$1.5M
181154342814$1.5M
191861425282$1.2M
201598988180$1.2M

Showing top 20 of 747 providers billing this code