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See a sample rate comparisonHCPCS G0052 Fee Schedule
Last Verified: September 2026
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.
Patients on peritoneal dialysis for any portion of the reporting month
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services MIPS Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G0052 by major payers:
$70.75
$17.71
$774.71
$N/A
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HCPCS G0052
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See a sample payer proposalHCPCS G0052 vs. Other MIPS Measures Codes
The HCPCS G0052 code is part of the Procedures / Professional Services services used for MIPS Measures. 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 G0052 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 |
|---|---|---|
| G0051-HCPCS | Low | Patients under hospice care in the current reporting month |
| G0052-HCPCS | Low | Patients on peritoneal dialysis for any portion of the reporting month |
| G0053-HCPCS | Low | Advancing rheumatology patient care mips value pathways |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0052. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0052 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.
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