HCPCS G0380 Fee Schedule

Last Verified: December 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.

Level 1 hospital emergency department visit provided in a type B emergency department; (the ED must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 CFR 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)

Key Fact	Detail
Service Type	• Procedures / Professional Services • Hospital Observation and Emergency Services
Complexity Level	Low

National average reimbursement for HCPCS G0380 by major payers:

$106.41

$61.80

$205.75

$41.85

Preview provider-level rates for...

For billing codeHCPCS G0380

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 G0380
United	G0380	$130.78	1396520862 - LAKE SURGICAL HOSPITAL SLIDELL, LLC	474228147 - (LA) LAKE SURGICAL HOSPITAL SLIDELL, LLC DBA SOUTHERN SURGICAL HOSPITAL	LA	General Acute Care Hospital (282N00000X)
United	G0380	$291.00	1295723229 - ST FRANCIS MEDICAL CENTER, INC	720408970 - (LA) ST FRANCIS MEDICAL CENTER INC	LA	General Acute Care Hospital (282N00000X)
United	G0380	$146.94	1992779482 - ANNA JAQUES HOSPITAL	42104338 - (MA) ANNA JAQUES HOSPITAL	MA	General Acute Care Hospital (282N00000X)
United	G0380	$188.63	1578568481 - SLIDELL MEMORIAL HOSPITAL, ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT #2	726014895 - (LA) SLIDELL MEMORIAL HOSPITAL	LA	General Acute Care Hospital (282N00000X)
United	G0380	$805.00	1104819366 - CHILDREN'S HOSPITAL	720467503 - CHILDRENS HOSPITAL INC	LA	Children's Hospital (282NC2000X)
United	G0380	$195.00	1275527889 - CANDLER HOSPITAL INCORPORATED	580593388 - CANDLER HOSPITAL INCORPORATED	GA	General Acute Care Hospital (282N00000X)
United	G0380	$329.00	1376591941 - HOSPITAL SERVICE DISTRICT 1 OF EAST BATON ROUGE PARISH, LANE REGIONAL MEDICAL CENTER	726015227	LA	General Acute Care Hospital (282N00000X)
United	G0380	$87.68	1619057155 - SABINE MEDICAL CENTER	262074318	LA	General Acute Care Hospital (282N00000X)
United	G0380	$87.51	1043392491 - DOCTORS' HOSPITAL OF SLIDELL, LLC, STERLING SURGICAL HOSPITAL	522363244 - (LA) DOCTORS HOSPITAL OF SLIDELL, LLC	LA	General Acute Care Hospital (282N00000X)
United	G0380	$489.00	1407947336 - CLHG-VILLE PLATTE LLC, MERCY REGIONAL MEDICAL CENTER	824681222	LA	General Acute Care Hospital (282N00000X)
United	G0380	$119.37	1225450588 - PARISH HOSPITAL SERVICE DISTRICT FOR THE PARISH OF ORLEANS, NEW ORLEANS EAST HOSPITAL	273335876	LA	General Acute Care Hospital (282N00000X)
United	G0380	$89.97	1144274127 - PROGRESSIVE ACUTE CARE DAUTERIVE, LLC, DAUTERIVE HOSPITAL	364756243 - (LA) PROGRESSIVE ACUTE CARE DAUTERIVE LLC	LA	General Acute Care Hospital (282N00000X)
United	G0380	$195.00	1275527889 - CANDLER HOSPITAL INCORPORATED	580593388 - CANDLER HOSPITAL INCORPORATED	GA	General Acute Care Hospital (282N00000X)
United	G0380	$195.00	1063406684 - SAINT JOSEPH'S HOSPITAL, INC.	580568702 - (GA) SAINT JOSEPHS HOSPITAL INC	GA	General Acute Care Hospital (282N00000X)
United	G0380	$200.00	1063406684 - SAINT JOSEPH'S HOSPITAL, INC.	580568702 - (GA) SAINT JOSEPHS HOSPITAL INC	GA	General Acute Care Hospital (282N00000X)
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 G0380 vs. Other Hospital Observation and Emergency Services Codes

The HCPCS G0380 code is part of the Procedures / Professional Services services used for Hospital Observation and Emergency 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 G0380 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
G0379-HCPCS	Moderate	Direct admission of patient for hospital observation care
G0380-HCPCS	Low	Level 1 hospital emergency department visit provided in a type B emergency department; (the ED must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 CFR 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
G0381-HCPCS	Low	Level 2 hospital emergency department visit provided in a type B emergency department; (the ED must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 CFR 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0380. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the G0380 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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