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See a sample rate comparisonHCPCS G0465 Fee Schedule
Medicare rates as of October 2026
HCPCS G0465 is classified under Procedures / Professional Services, in the Miscellaneous Services subgroup.
Autologous platelet rich plasma (PRP) or other blood-derived product for diabetic chronic wounds/ulcers, using an FDA-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Miscellaneous Services |
| Hospital Outpatient Group (APC) | APC 5054 - Level 4 Skin Procedures |
| Common Revenue Codes | 07610361 |
| Medicare Fee Schedule | $1,063.49 national non-facility rate (2026)View Medicare rates for G0465 |
| Medicaid Fee Schedule | $786.755 median of the 2 states in the free previewView Medicaid rates for G0465 |
National average reimbursement for HCPCS G0465 by major payers:
$894.01
BCBS / Anthem
$1,018.62
UnitedHealthcare
$701.26
Aetna
$440.82
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0465.
HCPCS G0465
5 of 25 sample ratesHigher to lower in this preview
Our Lady Of The Angels Hospital, Inc., Our Lady Of The Angels Hospital
Our Lady Of The Angels Hospital Inc
$2,922.86Published rateBrooks County Hospital
$1,896.95Published rateTift Regional Health System Inc., Tift Regional Medical Center
Tift Regional Health System Inc
$1,216.47Published rateMichael Koch
Chestatee Pathology Associates PC
$826.23Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$118.19Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0465 vs. Other Miscellaneous Services Codes
The table lists codes related to G0465. Select one to see its fee schedule.
| Code | Description |
|---|---|
| G0463-HCPCS | Hospital outpatient clinic visit for assessment and management of a patient |
| G0465-HCPCS | Autologous platelet rich plasma (PRP) or other blood-derived product for diabetic chronic wounds/ulcers, using an FDA-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment) |
| G0466-HCPCS | Federally qualified health center (FQHC) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a FQHC practitioner during which time one or more FQHC services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a FQHC visit |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0465. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0465 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 G0465 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns HCPCS G0465 to APC 5054 (Level 4 Skin Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
Which revenue codes are billed with HCPCS G0465?
Hospital price transparency files list HCPCS G0465 under these revenue codes: 0761 and 0361. A revenue code names the hospital department or charge category for the line; it does not change what the service is.