HCPCS G2212 Fee Schedule

Last Verified: November 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

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 qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes)

Key Fact	Detail
Service Type	• Procedures / Professional Services • Evaluation and Care Management Services
Common Place of Service
Common Modifiers
Complexity Level	Moderate

National average reimbursement for HCPCS G2212 by major payers:

$38.67

$43.04

$39.25

$34.61

Preview provider-level rates for...

For billing codeHCPCS G2212

Payer	Code	Rate	NPI	Tax ID	State	Specialty
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS G2212
United	G2212	$181.22	1851706196 - NEHA PATEL	752740653 - (TX) MAGELLA MEDICAL ASSOCIATES BILLING INC	TX	Neonatal-Perinatal Medicine Physician (2080N0001X)
United	G2212	$125.54	1386617876 - BARRY COFER	752740653 - (TX) MAGELLA MEDICAL ASSOCIATES BILLING INC	TX	Pediatric Surgery Physician (2086S0120X)
United	G2212	$33.84	1043789308 - PATRICIA CHACON	204923281 - MEMORIAL HERMANN MEDICAL GROUP	TX	Family Nurse Practitioner (363LF0000X)
United	G2212	$51.86	1033525597 - HASAAN SIDDIQUI	760459500 - U T PHYSICIANS	TX	Diagnostic Radiology Physician (2085R0202X)
United	G2212	$47.63	1104045897 - HILDA TSO	760459500 - U T PHYSICIANS	TX	Diagnostic Radiology Physician (2085R0202X)
United	G2212	$33.95	1083001424 - MARTHA VERA	260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP	TX	Certified Registered Nurse Anesthetist (367500000X)
United	G2212	$47.63	1831115922 - DAVID ROBINSON	760459500 - U T PHYSICIANS	TX	Emergency Medicine Physician (207P00000X)
United	G2212	$51.86	1699018234 - SAMEEKSHA BHAMA	760459500 - U T PHYSICIANS	TX	Hematology & Oncology Physician (207RH0003X)
United	G2212	$28.12	1093196529 - JENNIFER REEVES	260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP	TX	Family Nurse Practitioner (363LF0000X)
United	G2212	$51.86	1497406441 - SARAH KEHRER	760459500 - U T PHYSICIANS	TX	Physician Assistant (363A00000X)
United	G2212	$51.86	1124414412 - DANIEL MILES	760459500 - U T PHYSICIANS	TX	Vascular Surgery Physician (2086S0129X)
United	G2212	$44.95	1699043687 - LYUBOV OLENINA	204923281 - MEMORIAL HERMANN MEDICAL GROUP	TX	Endocrinology, Diabetes & Metabolism Physician (207RE0101X)
United	G2212	$47.63	1215357355 - NATASHA KLIMAS	760459500 - U T PHYSICIANS	TX	Anatomic Pathology & Clinical Pathology Physician (207ZP0102X)
United	G2212	$51.86	1124128749 - DEMETRIOS PETROPOULOS	760459500 - U T PHYSICIANS	TX	Pediatric Hematology & Oncology Physician (2080P0207X)
United	G2212	$61.09	1275721706 - MANUEL SILVA CARMONA	260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP	TX	Pediatric Pulmonology Physician (2080P0214X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

Want to see your competitors' rates?

Start your trial today to unlock complete access to provider rates and fee schedules in your area.

Run a free sample report

Here's what you can do with PayerPrice

Renegotiate your managed care contracts

Benchmark your current rates against market averages to identify opportunities for rate optimization.

Prospect for new business using fee schedules

Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.

Integrate real-time payer data into your workflows

Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.

Explore state-level rates

PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.

HCPCS G2212 vs. Other Evaluation and Care Management Services Codes

The HCPCS G2212 code is part of the Procedures / Professional Services services used for Evaluation and Care Management Services. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS G2212 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
G2211	Low	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)
G2212	Low	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 qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes)
G2213	Low	Initiation of medication for the treatment of opioid use disorder in the emergency department setting, including assessment, referral to ongoing care, and arranging access to supportive services (list separately in addition to code for primary procedure)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G2212. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the G2212 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like HCPCS G2212) and we'll show you how you compare in 15 minutes or less.

Schedule a Demo

Medicare Reimbursement Lookup Tool

PayerPrice provides a free medicare lookup tool for physician fee schedule, drug ASP, MS-DRG weights, anesthesia conversion factors and other medicare related data.

Search Medicare Rates