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See a sample rate comparisonHCPCS G0413 Fee Schedule
Medicare rates as of October 2026
HCPCS G0413 is classified under Procedures / Professional Services, in the Fracture Treatment subgroup.
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)
| 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 | 03600761 |
| Medicare Fee Schedule | $977.98 national non-facility rate (2026)View Medicare rates for G0413 |
| Medicaid Fee Schedule | $806.80 median of the 8 states in the free previewView Medicaid rates for G0413 |
National average reimbursement for HCPCS G0413 by major payers:
$1,289.39
BCBS / Anthem
$1,442.33
UnitedHealthcare
$1,249.77
Aetna
$1,134.04
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0413.
HCPCS G0413
5 of 25 sample ratesHigher to lower in this preview
Christus Health Southwestern Louisiana, Christus St. Patrick Hospital
Christus Health Southwestern Louisiana
$9,520.00Published rateBrass Partnership In Commendam
$2,831.00Published rateNew Orleans La Uptown West Bank Endoscopy Asc LLC, Mga Gastrointestinal Diagnostic And Therapeutic Center
$1,546.00Published rateHouma Surgi-Center, Inc & Urology Clinic
Houma Surgi-Center & Urology Clinic (Amc)
$1,263.00Published rateThe Alexandria Ophthalmology Asc LLC, Wallace Laser And Surgery Center
$760.00Published rate
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See a sample payer proposalHCPCS G0413 vs. Other Fracture Treatment Codes
The table lists codes related to G0413. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 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) |
| G0414-HCPCS | Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0413. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0413 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 G0413 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns HCPCS G0413 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 G0413 in an ambulatory surgery center?
CMS lists HCPCS G0413 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with HCPCS G0413?
Hospital price transparency files list HCPCS G0413 under these revenue codes: 0360 and 0761. A revenue code names the hospital department or charge category for the line; it does not change what the service is.