Complex office visit add-on

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PR Visit Complexity E&M Service Serious/Complex Condition

Payers reporting HCPCS G2211

Payer pricing summary

Low

Average

$2.4k

Median

$29

High

$54.1k

Payer rate distribution

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Filter by billing class

#
1	Medicare professional · fee schedule · outpatient · +13 other terms	24	$15	$15	$2	12%	57,978	$11 – $17
2	Ucare professional · fee schedule · outpatient · +13 other terms	30	$15	$15	$3	21%	11,560–11,605	$10 – $25
3	Medica professional · fee schedule · outpatient · +17 other terms	33	$17	$17	$4	24%	9,864–9,918	$11 – $34
4	Regence professional · fee schedule · both · +12 other terms	18	$17	$20	$7	34%	7,979–7,997	$12 – $36
5	Molina professional · fee schedule · both · +20 other terms	41	$15	$13	$5	40%	2,565–2,592	$0 – $26
6	WellCare professional · fee schedule · outpatient · +20 other terms	40	$15	$15	$2	10%	806–815	$10 – $18
7	Cigna fee schedule · both · +23 other terms	48	$30	$24	$13	55%	707–752	$0 – $78
8	Optum professional · fee schedule · outpatient · +18 other terms	38	$15	$15	$2	12%	698–707	$11 – $18
9	Ambetter fee schedule · both · +17 other terms	14	$20	$22	$7	29%	460	$13 – $31
10	Premera professional · fee schedule · both · +8 other terms	9	$23	$25	$6	23%	445–463	$17 – $32
11	Tricare professional · fee schedule · outpatient · +13 other terms	24	$14	$14	$1	9%	237–246	$12 – $17
12	Healthcare Highways facility · percent of total billed charges · outpatientfrom % of charges	2	$19	$19	$4	23%	94–112	$14 – $25
13	Oscar professional · fee schedule · outpatient · +14 other terms	17	$14	$16	$3	21%	91–100	$11 – $23
14	Highmark professional · fee schedule · both · +13 other terms	22	$16	$17	$5	29%	81–162	$9 – $32
15	UnitedHealthcare fee schedule · outpatient · +30 other terms	128	$16	$22	$14	61%	33–51	$9 – $152
16	Aetna fee schedule · outpatient · +25 other terms	110	$15	$20	$46	232%	21	$0 – $619
17	Humana fee schedule · outpatient · +24 other terms	88	$15	$19	$17	90%	12–21	$0 – $152
18	Caresource professional · fee schedule · both · +13 other terms	24	$15	$15	$3	17%	12	$9 – $22
19	Carefirst professional · fee schedule · both · +5 other terms	19	$17	$18	$6	32%	4–40	$9 – $32
20	Devoted professional · fee schedule · outpatient · +13 other terms	26	$15	$15	$2	11%	3–30	$11 – $18
21	Excellus professional · fee schedule · both · +11 other terms	22	$16	$17	$6	34%	3–30	$9 – $38
22	Blue Cross Blue Shield fee schedule · outpatient · +26 other terms	132	$53	$58	$43	74%	1–10	$0 – $403
23	Anthem fee schedule · outpatient · +18 other terms	48	$41	$65	$48	74%	—	$10 – $194
24	Kaiser fee schedule · outpatient · +15 other terms	36	$16	$52	$96	184%	—	$11 – $523
25	Bcbs Tx fee schedule · outpatient · +2 other terms	30	$70	$64	$24	37%	—	$21 – $119

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