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See a sample rate comparisonHCPCS G0428 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.
Collagen meniscus implant procedure for filling meniscal defects (e.g., CMI, collagen scaffold, Menaflex)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Filler Procedures |
| Complexity Level | High |
National average reimbursement for HCPCS G0428 by major payers:
$1,875.01
$54.00
$807.26
$471.08
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HCPCS G0428
5 of 25 sample ratesHigher to lower in this preview
Our Lady Of Lourdes Regional Medical Center,Inc
Our Lady Of Lourdes Regional Medical Center Inc
$21,216.00Published ratePiedmont Athens Regional Medical Center, Inc.
Piedmont Athens Regional Medical Center Inc
$4,336.00Published rateBrass Partnership In Commendam
$1,100.00Published rateVivere Health New Orleans, LLC, Vivere Audubon Surgery Center
Vivere Health New Orleans LLC
$523.00Published rateMesquite Surgery Center LLC
$105.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0428 vs. Other Filler Procedures Codes
The HCPCS G0428 code is part of the Procedures / Professional Services services used for Filler Procedures. 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 G0428 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 |
|---|---|---|
| G0427-HCPCS | Moderate | Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth |
| G0428-HCPCS | High | Collagen meniscus implant procedure for filling meniscal defects (e.g., CMI, collagen scaffold, Menaflex) |
| G0429-HCPCS | Low | Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (LDS) (e.g., as a result of highly active antiretroviral therapy) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0428. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0428 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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