Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS G0416 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Gross and Microscopic Examinations, Prostate Biopsy |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for G0416 |
National average reimbursement for HCPCS G0416 by major payers:
$424.77
$398.38
$517.14
$401.96
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0416.
HCPCS G0416
5 of 25 sample ratesHigher to lower in this preview
Fabiana Perna
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$421.98Published rateAndrea Torres
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$358.69Published rateSarah Zhu
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$194.94Published rateNikhil Bhatia
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$192.64Published rateDalila Belinc
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$163.75Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS G0416 vs. Other Gross and Microscopic Examinations, Prostate Biopsy Codes
The HCPCS G0416 code is part of the Procedures / Professional Services services used for Gross and Microscopic Examinations, Prostate Biopsy. 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 G0416 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 |
|---|---|---|
| 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 |
| G0420-HCPCS | Low | Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0416. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0416 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS G0416) and we'll show you how you compare in 15 minutes or less.