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See a sample rate comparisonHCPCS G0516 Fee Schedule
Medicare rates as of October 2026
HCPCS G0516 is classified under Procedures / Professional Services, in the Other Services subgroup.
Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Other Services |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $175.02 national non-facility rate (2026) · View Medicare rates for G0516 |
| Medicaid Fee Schedule | $137.81 median of the 8 states in the free preview · View Medicaid rates for G0516 |
National average reimbursement for HCPCS G0516 by major payers:
$245.30
BCBS / Anthem
$322.16
UnitedHealthcare
$222.14
Aetna
$213.74
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0516.
HCPCS G0516
5 of 25 sample ratesHigher to lower in this preview
Southern Regional Medical Corporation, Leonard J. Chabert Medical Center
$809.95Published rateLafayette Surgery Center Limited Partnership
$522.00Published rateJoint Replacement Center Of Louisiana
Joint Replacement Center Of Lous
$113.00Published rateNorthlake Endoscopy, LLC
Northlake Endoscopy LLC
$93.00Published rateSurgery Center Of West Monroe, LLC
$70.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0516 vs. Other Other Services Codes
The table lists codes related to G0516. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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) |
| G0516-HCPCS | Moderate | Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant) |
| G0517-HCPCS | Moderate | Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0516. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0516 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
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