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See a sample rate comparisonHCPCS S4016 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Frozen in vitro fertilization cycle, case rate
| Key Fact | Detail |
|---|---|
| Service Type | Temporary National Codes (Non-Medicare) Assorted Obstetrical and Fertility Services |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center 19 - Off Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for HCPCS S4016 by major payers:
$2,917.02
$866.00
$3,631.80
$2,629.41
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HCPCS S4016
5 of 25 sample ratesHigher to lower in this preview
Andy Huang
Reproductive Partners Medical Group, Inc.
$2,107.00Published rateRachel Whynott
Reproductive Partners Medical Group La Jolla Inc
$2,107.00Published rateCarrie Wambach
Reproductive Partners Medical Group, Inc.
$2,107.00Published rateHui-Chun Su
Reproductive Partners Medical Group La Jolla Inc
$2,107.00Published rateSara Kostant
Premise Health Of New York Medical PC
$1,370.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS S4016 vs. Other Assorted Obstetrical and Fertility Services Codes
The HCPCS S4016 code is part of the Temporary National Codes (Non-Medicare) services used for Assorted Obstetrical and Fertility 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 S4016 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 |
|---|---|---|
| S4015-HCPCS | High | Complete in vitro fertilization cycle, not otherwise specified, case rate |
| S4016-HCPCS | High | Frozen in vitro fertilization cycle, case rate |
| S4017-HCPCS | High | Incomplete cycle, treatment cancelled prior to stimulation, case rate |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S4016. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S4016 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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