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HCPCS G0416

G0416 AP Bill Prostate Biopsy GM Any Number Specim

Reported by 80 hospitals in the network under the other methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a payer-specific billing methodology not covered by the standard categories.

National pricing summary

Low

$102

Average

$650

Median

$451

High

$13.9k

Hospitals reporting this code

#HospitalLocation
1IOM Health System LPFort Wayne, IN$172$840$746$1.6k$144
2Dukes Health System LLCPeru, IN$69$840$614$840$329
3Warsaw Health System LLCWarsaw, IN$172$840$748$1.6k$127
4Lutheran Musculoskeletal Center LLCFort Wayne, IN$182$840$718$1.6k$152
5St. Joseph Health System, LLCIN 46802, IN$172$840$759$1.6k$141
6Dupont Hospital LLCIN 46825, IN$172$840$746$1.6k$144
7Durant HMA LLCDurant, OK$150$150$230$432$115
8Wesley Health System LLCHattiesburg, MS$132$366$481$1.2k$270
9Jackson HMA LLCMS 39204, MS$160$416$596$1.8k$433
10Porter Hospital LLCValparaiso, IN$71$840$687$1.5k$245
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