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See a sample rate comparisonHCPCS G0412 Fee Schedule
Medicare rates as of October 2026
HCPCS G0412 is classified under Procedures / Professional Services, in the Fracture Treatment subgroup.
Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Fracture Treatment |
| Hospital Outpatient Group (APC) | APC 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $669.02 national non-facility rate (2026)View Medicare rates for G0412 |
| Medicaid Fee Schedule | $550.615 median of the 8 states in the free previewView Medicaid rates for G0412 |
National average reimbursement for HCPCS G0412 by major payers:
$919.24
BCBS / Anthem
$999.05
UnitedHealthcare
$758.72
Aetna
$774.24
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0412.
HCPCS G0412
5 of 25 sample ratesHigher to lower in this preview
Our Lady Of Lourdes Regional Medical Center,Inc
Our Lady Of Lourdes Regional Medical Center Inc
$28,971.00Published rateMaricopa County Special Health Care District, Valleywise Health
$8,405.00Published rateMaricopa County Special Health Care District, Maricopa Integrated Health
$7,224.00Published rateHospital Service District No. 1 Of Iberia Parish, Iberia Medical Center
$7,166.00Published rateShreveport Surgery Center Ptrshp
Shreveport Surgery Center Of Caddo Parish, Inc.
$2,122.00Published rate
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See a sample payer proposalHCPCS G0412 vs. Other Fracture Treatment Codes
The table lists codes related to G0412. Select one to see its fee schedule.
| Code | Description |
|---|---|
| G0411-HCPCS | Interactive group psychotherapy, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes |
| G0412-HCPCS | Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed |
| G0413-HCPCS | Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0412. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0412 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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Frequently Asked Questions
What APC is HCPCS G0412 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns HCPCS G0412 to APC 5114 (Level 4 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for HCPCS G0412 in an ambulatory surgery center?
CMS lists HCPCS G0412 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with HCPCS G0412?
Hospital price transparency files list HCPCS G0412 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.