HCPCS G0414 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Procedures / Professional Services • Fracture Treatment |
| Complexity Level | High |
National average reimbursement for HCPCS G0414 by major payers:
$1,203.15
$1,357.75
$1,052.98
$1,069.92
| 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 G0414 | ||||||
United | G0414 | $6365.00 | 1437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC | 453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | G0414 | $22760.00 | 1528069218 - NORTHSHORE REGIONAL MEDICAL CENTER DBA THE SURGERY SUITE, THE SURGERY SUITE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | G0414 | $1956.00 | 1659356392 - LASER & CATARACT CENTER OF SHREVEPORT LLC, EYE SURGERY CENTER | 721382751 - (LA) LASER CATARACT CENTER OF SHREVEPORT LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | G0414 | $2928.00 | 1447377767 - HOSPITAL SERVICE DISTRICT NO. 1 OF THE PARISH OF VERMILION, ABROM KAPLAN MEMORIAL HOSPITAL | 472540179 - (LA) KAPLAN GENERAL HOSPITAL INC | LA | Critical Access Hospital (282NC0060X) |
United | G0414 | $5450.00 | 1356490817 - CHRISTUS CABRINI SURGERY CENTER, LLC, CHRISTUS CABRINI SURGERY CENTER | 204705651 - CHRISTUS CABRINI SURGERY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | G0414 | $2191.00 | 1114035946 - ACADIANA ENDOSCOPY CENTER, INC., THE ENDOSCOPY CENTER | 721121943 - (LA) LAFAYETTE GENERAL ENDOSCOPY CENTER, INC. | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | G0414 | $7888.00 | 1104181247 - ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC | 455502071 - (LA) ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | G0414 | $2012.50 | 1457345910 - BRADLEY SMITH | 561079264 - EMERGEORTHO, P.A. | NC | Orthopaedic Surgery Physician (207X00000X) |
United | G0414 | $10646.00 | 1093876997 - PHC-MORGAN CITY LP, TECHE REGIONAL MEDICAL CENTER | 842237042 | LA | Rural Acute Care Hospital (282NR1301X) |
United | G0414 | $6365.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | G0414 | $7224.00 | 1043679327 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, VALLEYWISE HEALTH | 860830701 | AZ | Adult Mental Health Clinic/Center (261QM0850X) |
United | G0414 | $858.00 | 1144227935 - CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE, TRINITY MEDICAL | 720578642 - (LA) RIVERLAND MEDICAL CENTER | LA | Critical Access Hospital (282NC0060X) |
United | G0414 | $7224.00 | 1306265145 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, MARICOPA INTEGRATED HEATLH | 860830701 | AZ | Federally Qualified Health Center (FQHC) (261QF0400X) |
United | G0414 | $3199.00 | 1063649978 - IMPERIAL CALCASIEU SURGICAL CENTER LLC, CHRISTUS IMPERIAL CALCASIEU SURGICAL CENTER | 205109610 - (LA) IMPERIAL CALCASIEU SURGICAL CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | G0414 | $7224.00 | 1003273855 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, MARICOPA SPECIAL HEALTH CARE DISTRICT | 860830701 | AZ | Adult Mental Health Clinic/Center (261QM0850X) |
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 G0414 vs. Other Fracture Treatment Codes
The HCPCS G0414 code is part of the Procedures / Professional Services services used for Fracture Treatment. 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 G0414 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 |
|---|---|---|
| G0413-HCPCS | High | 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 | High | 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) |
| G0415-HCPCS | High | Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (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 G0414. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0414 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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