Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preve
Medicare pricing data for 498 providers across 30 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 preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preve (HCPCS code G0513) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $61.58, but hospitals typically charge $125.86 — a 2.0x 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 $61.58, your out-of-pocket cost would be approximately $12.32. 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 2.0x more than what Medicare allows for this procedure. Medicare actually pays $61.58 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Virginia | $69 | $100 | 4 | 113 | +12.2% |
| Maryland | $69 | $97 | 9 | 88 | +11.4% |
| New Jersey | $68 | $90 | 3 | 168 | +10.5% |
| California | $65 | $136 | 31 | 1,309 | +5.5% |
| Massachusetts | $64 | $104 | 5 | 101 | +4.3% |
| Connecticut | $64 | $110 | 8 | 52 | +4.1% |
| Florida | $64 | $89 | 11 | 620 | +3.2% |
| Colorado | $63 | $108 | 24 | 1,071 | +1.6% |
| Georgia | $63 | $142 | 15 | 781 | +1.6% |
| Illinois | $63 | $142 | 37 | 3,251 | +1.5% |
| Pennsylvania | $62 | $111 | 24 | 210 | +0.8% |
| Michigan | $62 | $96 | 14 | 140 | +0.6% |
| New York | $62 | $79 | 25 | 573 | -0.0% |
| Washington | $61 | $186 | 7 | 268 | -0.2% |
| North Dakota | $61 | $73 | 2 | 14 | -0.7% |
| Oregon | $61 | $147 | 42 | 274 | -1.2% |
| Indiana | $61 | $155 | 1 | 127 | -1.7% |
| Louisiana | $60 | $120 | 6 | 18 | -2.2% |
| Alabama | $60 | $70 | 7 | 262 | -3.0% |
| Tennessee | $60 | $108 | 13 | 537 | -3.2% |
| New Mexico | $59 | $148 | 3 | 39 | -3.9% |
| Texas | $59 | $111 | 69 | 1,822 | -4.3% |
| Oklahoma | $59 | $175 | 6 | 147 | -4.6% |
| Utah | $59 | $104 | 6 | 226 | -4.6% |
| New Hampshire | $57 | $236 | 25 | 399 | -6.8% |
| North Carolina | $57 | $160 | 57 | 223 | -7.4% |
| Idaho | $56 | $69 | 15 | 155 | -8.6% |
| Hawaii | $55 | $75 | 1 | 14 | -10.8% |
| Nevada | $54 | $90 | 6 | 88 | -12.7% |
| Arizona | $53 | $98 | 4 | 151 | -14.6% |
⚠️ 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