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 G0513 Fee Schedule
Medicare rates as of October 2026
HCPCS G0513 is classified under Procedures / Professional Services, in the Other Services subgroup.
Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Other Services |
| Complexity Level | Low |
| Medicare Fee Schedule | $64.80 national non-facility rate (2026) · View Medicare rates for G0513 |
| Medicaid Fee Schedule | $56.41 median of the 8 states in the free preview · View Medicaid rates for G0513 |
National average reimbursement for HCPCS G0513 by major payers:
$83.38
BCBS / Anthem
$81.47
UnitedHealthcare
$64.74
Aetna
$67.45
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0513.
HCPCS G0513
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$159.30Published rateGrady Memorial Hospital Corporation, Grady Health Systems
Emory University
$131.77Published rateMiguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
$88.80Published rateTift Regional Health System Inc., Tift Regional Medical Center
Tift Regional Health System Inc
$73.15Published rateAlicia Encinas
Miguel A Arenas Md PC
$50.45Published 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 G0513 vs. Other Other Services Codes
The table lists codes related to G0513. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G0513-HCPCS | Low | Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service) |
| G0514-HCPCS | Low | Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code G0513 for additional 30 minutes of preventive service) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0513. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0513 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 G0513) and we'll show you how you compare in 15 minutes or less.