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See a sample rate comparisonHCPCS G0415 Fee Schedule
Medicare rates as of October 2026
HCPCS G0415 is classified under Procedures / Professional Services, in the Fracture Treatment subgroup.
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)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Fracture Treatment |
| Hospital Outpatient Group (APC) | APC 5113 - Level 3 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | G2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $1,239.17 national non-facility rate (2026)View Medicare rates for G0415 |
| Medicaid Fee Schedule | $1,044.485 median of the 8 states in the free previewView Medicaid rates for G0415 |
National average reimbursement for HCPCS G0415 by major payers:
$1,639.89
BCBS / Anthem
$1,860.97
UnitedHealthcare
$1,455.72
Aetna
$1,448.87
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0415.
HCPCS G0415
5 of 25 sample ratesHigher to lower in this preview
Keck Medical Center Of Usc
$21,313.00Published rateMaricopa County Special Health Care District, Valleywise Health
$8,405.00Published rateOlol Pontchartrain Surgery Center, LLC, Our Lady Of The Lake Pontchartrain Surgery Center
Olol Pontchartrain Surgery Cente
$3,475.00Published rateOutpatient Eye Surgery Center
$2,056.00Published rateCarolina Radiology Associates LLC
Carolina Radiology Associates, LLC
$1,148.63Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0415 vs. Other Fracture Treatment Codes
The table lists codes related to G0415. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 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) |
| G0415-HCPCS | 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) |
| G0416-HCPCS | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0415. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0415 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 G0415 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns HCPCS G0415 to APC 5113 (Level 3 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for HCPCS G0415 in an ambulatory surgery center?
CMS lists HCPCS G0415 with ASC payment indicator G2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with HCPCS G0415?
Hospital price transparency files list HCPCS G0415 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.