HCPCS G0556 HCPCS - Temporary Procedures
Adv prim care mgmt lvl 1 Cost
Body System: General
Medicare Facility Rate
$11
CMS PFS CY2026
Medicare Non-Facility Rate
$16
Office/clinic setting
Hospital Outpatient
$38
OPPS rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.25
Work RVU
0.06
Facility PE RVU
0.02
Malpractice RVU
0.49
Total RVU
Frequently Asked Questions
How much does Adv prim care mgmt lvl 1 cost?
The Medicare facility rate is $11. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $38.
How much does Adv prim care mgmt lvl 1 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 $11.