HCPCS G0268 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Procedures / Professional Services • Miscellaneous Diagnostic and Therapeutic Services |
| Complexity Level | Low |
National average reimbursement for HCPCS G0268 by major payers:
$61.67
$64.39
$59.05
$56.18
| 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 G0268 | ||||||
United | G0268 | $92.03 | 1114082385 - SHARON LEWIS | 232865181 | PA | Neuromuscular Medicine (Psychiatry & Neurology) Physician (2084N0008X) |
United | G0268 | $112.98 | 1356837009 - SHU CAO | 232865181 | FL | Student in an Organized Health Care Education/Training Program (390200000X) |
United | G0268 | $112.98 | 1245689298 - MARCOS DEVARIE HORNEDO | 232865181 | PR | Surgery Physician (208600000X) |
United | G0268 | $92.03 | 1104356245 - VALERIE SIDHOUM | 232865181 | PA | Neurology Physician (2084N0400X) |
United | G0268 | $112.98 | 1952371734 - ALEXANDER GOLDBERG | 232865181 | NJ | Family Medicine Physician (207Q00000X) |
United | G0268 | $112.98 | 1598298564 - ABASS NOOR | 232865181 | PA | Diagnostic Radiology Physician (2085R0202X) |
United | G0268 | $112.98 | 1831844075 - MARIA ZIADI | 232865181 | PA | Cardiovascular Disease Physician (207RC0000X) |
United | G0268 | $112.98 | 1225658412 - MOHSIN ALI | 232865181 | NJ | Student in an Organized Health Care Education/Training Program (390200000X) |
United | G0268 | $112.98 | 1811060247 - PHILIP BERGEY | 232865181 | PA | Diagnostic Radiology Physician (2085R0202X) |
United | G0268 | $112.98 | 1669658084 - SAJIDA MOKHASHI | 232865181 | NJ | Geriatric Medicine (Family Medicine) Physician (207QG0300X) |
United | G0268 | $112.98 | 1790313518 - SYEDA AHMED-ZAIDI | 232865181 | NJ | Student in an Organized Health Care Education/Training Program (390200000X) |
United | G0268 | $70.67 | 1336235191 - ANISH SHETH | 232865181 | NJ | Gastroenterology Physician (207RG0100X) |
United | G0268 | $92.03 | 1013943257 - FRANK DU PONT | 232865181 | PA | Diagnostic Radiology Physician (2085R0202X) |
United | G0268 | $92.03 | 1881759827 - PAMELA LEVIN | 232865181 | PA | Female Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician (207VF0040X) |
United | G0268 | $70.67 | 1578603692 - FREDRICK WEINBERG | 232865181 | NJ | Cardiovascular Disease Physician (207RC0000X) |
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 |
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HCPCS G0268 vs. Other Miscellaneous Diagnostic and Therapeutic Services Codes
The HCPCS G0268 code is part of the Procedures / Professional Services services used for Miscellaneous Diagnostic and Therapeutic 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 G0268 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 |
|---|---|---|
| G0260-HCPCS | Moderate | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography |
| G0268-HCPCS | Low | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing |
| G0269-HCPCS | High | Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0268. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0268 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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