HCPCS G0138 HCPCS - Temporary Procedures

How Much Does Intravenous Cipaglucosidase Alfa-atga Cost?

Also known as: Iv cipaglucosidase alfa-atga (CPT G0138)

Intravenous Cipaglucosidase Alfa-atga (CPT G0138) costs $196 at Medicare rates. Hospital outpatient rate: $651.

Cost Comparison by Payer

How much Iv cipaglucosidase alfa-atga costs across different settings and payers

Medicare
Facility rate
$196
Hospital Outpatient
OPPS rate
$651
Medicare (Facility)
$196
CMS PFS 2026 national rate
Hospital Outpatient
$651
OPPS rate

Procedures Commonly Done Together

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How to Reduce Your Cost for Iv cipaglucosidase alfa-atga

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

0.21
Work RVU
5.62
Practice Expense RVU
0.05
Malpractice RVU
5.88
Total RVU

Payment = Total RVU (5.88) x CF ($33.40) = $196

Frequently Asked Questions

How much does Iv cipaglucosidase alfa-atga cost?

The Medicare facility rate for Iv cipaglucosidase alfa-atga is $196. In a hospital outpatient setting, the rate is $651. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Iv cipaglucosidase alfa-atga cost without insurance?

Without insurance, the cost of Iv cipaglucosidase alfa-atga can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Iv cipaglucosidase alfa-atga?

Most commercial health insurance plans and Medicare cover Iv cipaglucosidase alfa-atga when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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