RxDoctor Payments Data

HCPCS G0260

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography

$292.85Medicare-allowed amount per service, averaged across 90,972 services
Providers submitted
$2819.43

Asking price, not received

Medicare allowed
$292.85

The fee schedule figure

Medicare paid
$229.78

Balance is patient coinsurance

Providers submitted an average of $2819.43 for this code and Medicare allowed $292.859.6× 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 $229.78 (78%); the rest is the patient’s coinsurance and deductible.

Services
90,972

Medicare Part B, 2024

Beneficiaries
47,582
Providers billing it
980
Total allowed
$26,641,150

Services × allowed amount

What Medicare pays for HCPCS G0260

Across 90,972 services billed by 980 providers to 47,582 beneficiaries, Medicare allowed an average of $292.85 per service. That is 1.9 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 G0260

SpecialtyServicesBeneficiariesAvg allowedProviders
Ambulatory Surgical Center90,97247,582$292.85980

G0260 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
California12,140$349.10$226.16138
Georgia10,132$280.23$230.4290
Florida8,553$268.20$226.4775
Texas7,530$283.31$233.0479
Maryland4,913$284.48$230.2170
Arizona4,123$289.81$231.2737
Pennsylvania3,377$283.87$232.9239
Indiana2,630$289.09$236.9639
Ohio2,574$277.65$235.9027
Colorado2,547$287.04$230.8523
New York2,462$316.60$235.9521
Minnesota2,195$291.49$227.1719
Oregon2,030$309.26$213.1218
Mississippi2,009$262.88$237.6516
Illinois2,000$288.69$227.8216
Wisconsin1,973$288.38$231.8825
Tennessee1,736$265.97$235.0016
Louisiana1,726$265.74$235.6421
New Jersey1,713$320.81$238.3541
Kansas1,334$276.19$231.4314
Washington1,239$322.01$237.3316
Idaho1,230$277.86$230.089
Arkansas925$271.18$235.8912
Missouri842$281.83$233.5512
South Carolina837$290.78$244.575
Delaware775$292.27$228.866
Connecticut774$317.95$233.697
Alabama733$247.81$226.5313
Michigan717$275.02$228.9611
Nevada644$320.24$239.9011
Kentucky522$283.64$238.814
Nebraska496$276.77$231.488
Utah458$278.60$228.413
Massachusetts447$292.06$232.754
North Dakota394$312.91$266.023
New Hampshire330$313.42$245.436
New Mexico324$274.53$222.974
Wyoming296$272.10$224.354
Iowa244$273.53$230.302
Montana241$274.10$228.642
Rhode Island212$265.79$209.492
Oklahoma171$275.37$225.673
South Dakota165$267.46$232.703
North Carolina95$254.06$213.021
Virginia74$272.79$239.072
Alaska57$308.53$236.822
West Virginia33$224.53$233.191

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.