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See a sample rate comparisonHCPCS G0491 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.
Dialysis procedure at a medicare certified ESRD facility for acute kidney injury without ESRD
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Other Services |
| Complexity Level | Low |
National average reimbursement for HCPCS G0491 by major payers:
$99.56
$N/A
$1,006.36
$547.49
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HCPCS G0491
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See a sample payer proposalHCPCS G0491 vs. Other Other Services Codes
The HCPCS G0491 code is part of the Procedures / Professional Services services used for Other Services. 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 G0491 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 |
|---|---|---|
| G0490-HCPCS | Low | Face-to-face home health nursing visit by a rural health clinic (RHC) or federally qualified health center (FQHC) in an area with a shortage of home health agencies; (services limited to RN or LPN only) |
| G0491-HCPCS | Low | Dialysis procedure at a medicare certified ESRD facility for acute kidney injury without ESRD |
| G0492-HCPCS | Low | Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without ESRD |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0491. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0491 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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