RxDoctor Payments Data

HCPCS G0068

Professional services for the administration of anti-infective, pain management, chelation, pulmonary hypertension, inotropic, or other intravenous infusion drug or biological (excluding chemotherapy or other highly complex drug or biological) for each inf

$78.73Medicare-allowed amount per service, averaged across 21,370 services
Providers submitted
$113.84

Asking price, not received

Medicare allowed
$78.73

The fee schedule figure

Medicare paid
$62.25

Balance is patient coinsurance

Providers submitted an average of $113.84 for this code and Medicare allowed $78.731.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $62.25 (79%); the rest is the patient’s coinsurance and deductible.

Services
21,370

Medicare Part B, 2024

Beneficiaries
561
Providers billing it
22
Total allowed
$1,682,460

Services × allowed amount

What Medicare pays for HCPCS G0068

Across 21,370 services billed by 22 providers to 561 beneficiaries, Medicare allowed an average of $78.73 per service. That is 38.1 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills G0068

SpecialtyServicesBeneficiariesAvg allowedProviders
Home Infusion Therapy Services19,177429$76.0018
Pharmacy2,193132$102.624

G0068 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
New Jersey8,770$77.11$55.525
Pennsylvania1,949$111.51$87.593
Illinois1,718$50.42$38.331
Washington1,410$61.40$47.612
California1,276$44.11$34.861
Maryland1,207$36.86$27.151
Virginia1,201$54.87$38.711
New York1,176$104.72$72.702
Connecticut678$190.00$141.511
Delaware569$173.70$137.611
Alabama527$52.96$45.361
Arizona327$27.75$22.671
Kentucky318$168.18$141.701
Florida244$31.59$25.701

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.