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See a sample rate comparisonHCPCS G0451 Fee Schedule
Medicare rates as of October 2026
HCPCS G0451 is classified under Procedures / Professional Services, in the Counseling, Screening, and Prevention Services subgroup.
Development testing, with interpretation and report, per standardized instrument form
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Counseling, Screening, and Prevention Services |
| Hospital Outpatient Group (APC) | APC 5822 - Level 2 Health and Behavior Services |
| Common Revenue Codes | 04400420Sign up to view all 4 |
| Medicare Fee Schedule | $12.36 national non-facility rate (2026)View Medicare rates for G0451 |
| Medicaid Fee Schedule | $10.01 median of the 7 states in the free previewView Medicaid rates for G0451 |
National average reimbursement for HCPCS G0451 by major payers:
$13.91
BCBS / Anthem
$12.95
UnitedHealthcare
$11.89
Aetna
$12.65
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0451.
HCPCS G0451
5 of 25 sample ratesHigher to lower in this preview
Lallie Kemp Medical Ctr, Lallie Kemp Regional Medical Center
$140.05Published rateEmory Crawford Long Hospital
Emory University
$25.54Published rateNavicent Health Oconee, LLC, Navicent Health Baldwin
Navicent Health Oconee LLC
$13.96Published rateEmory Healthcare
Cardiac Arrhythmia Institute
$11.21Published rateMiguel Arenas
Miguel A Arenas Md PC
$8.11Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0451 vs. Other Counseling, Screening, and Prevention Services Codes
The table lists codes related to G0451. Select one to see its fee schedule.
| Code | Description |
|---|---|
| G0448-HCPCS | Insertion or replacement of a permanent pacing cardioverter-defibrillator system with transvenous lead(s), single or dual chamber with insertion of pacing electrode, cardiac venous system, for left ventricular pacing |
| G0451-HCPCS | Development testing, with interpretation and report, per standardized instrument form |
| G0452-HCPCS | Molecular pathology procedure; physician interpretation and report |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0451. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0451 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 G0451 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns HCPCS G0451 to APC 5822 (Level 2 Health and Behavior Services). An APC groups outpatient services that Medicare pays at the same base rate.
Which revenue codes are billed with HCPCS G0451?
Hospital price transparency files list HCPCS G0451 under these revenue codes: 0440, 0420, 0430 and 0918. A revenue code names the hospital department or charge category for the line; it does not change what the service is.