HCPCS G0516 HCPCS - Temporary Procedures
Insert drug del implant, >=4 Cost
Body System: General
Medicare Facility Rate
$85
CMS PFS CY2026
Medicare Non-Facility Rate
$175
Office/clinic setting
Hospital Outpatient
$5
OPPS rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
1.77
Work RVU
0.62
Facility PE RVU
0.15
Malpractice RVU
5.24
Total RVU
Frequently Asked Questions
How much does Insert drug del implant, >=4 cost?
The Medicare facility rate is $85. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $5.
How much does Insert drug del implant, >=4 cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $85.