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See a sample rate comparisonHCPCS G0415 Fee Schedule
Last Verified: September 2026
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.
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 |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for G0415 |
National average reimbursement for HCPCS G0415 by major payers:
$1,639.89
$1,860.97
$1,455.72
$1,448.87
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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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See a sample payer proposalHCPCS G0415 vs. Other Fracture Treatment Codes
The HCPCS G0415 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 G0415 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 |
|---|---|---|
| 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) |
| G0416-HCPCS | Moderate | 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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