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

What the market charges

Across 597 negotiated rates, the middle 80% fall between $30 and $321, with a median of $49.

What Medicare pays

Medicare allowed an average of $29 for this code, across 399,984 services billed by 5,098 providers. At the median, the market charges 1.7 times what Medicare pays for this code.

Where this is billed, and what it costs there

The states billing G0316 most, by Medicare service volume, each compared against the national average of $29. Each links to the providers Mishe lists there.

  • California — 547 providers billed it, Medicare allowed $31 — 7% above the national average
  • Pennsylvania — 309 providers billed it, Medicare allowed $28 — 3% below the national average
  • Illinois — 343 providers billed it, Medicare allowed $30 — 3% above the national average
  • Texas — 212 providers billed it, Medicare allowed $29 — level with the national average
  • Georgia — 129 providers billed it, Medicare allowed $28 — 3% below the national average
  • Florida — 216 providers billed it, Medicare allowed $28 — 3% below the national average
  • Maryland — 234 providers billed it, Medicare allowed $30 — 3% above the national average
  • Michigan — 259 providers billed it, Medicare allowed $28 — 3% below the national average

Deploy this for your team

Every figure on this page came from published payer and Medicare data, assembled by Mishe. The same pricing, claim-editing and care-pathway intelligence runs underneath the plans Mishe operates.

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