How much does Medicare pay for HCPCS G0453?

Medicare allowed an average of $32.00 per service and paid $25.43 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $544.50, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does G0453 pay differently in an office than a hospital?

Yes. The allowed amount averaged $33.23 in an office setting and $32.00 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills G0453 most?

Neurology, with 306,647 services from 399 clinicians. Next are Physical Medicine and Rehabilitation, Osteopathic Manipulative Medicine, Audiologist.

HCPCS G0453

Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)

$32.00Medicare-allowed amount per service, averaged across 361,928 services

Providers submitted

$544.50

Asking price, not received

Medicare allowed

$32.00

The fee schedule figure

Medicare paid

$25.43

Balance is patient coinsurance

Providers submitted an average of $544.50 for this code and Medicare allowed $32.00 — 17.0× 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 $25.43 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $33.23
Hospital / facility: $32.00

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,432 services were billed in an office setting and 360,496 in a facility.

Services: 361,928
Beneficiaries: 63,706
Providers billing it: 462
Total allowed: $11,581,696

What Medicare pays for HCPCS G0453

Across 361,928 services billed by 462 providers to 63,706 beneficiaries, Medicare allowed an average of $32.00 per service. That is 5.7 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 G0453

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurology	306,647	55,666	$32.03	399
Physical Medicine and Rehabilitation	17,256	2,462	$30.37	19
Osteopathic Manipulative Medicine	6,268	717	$31.32	2
Audiologist	5,933	505	$34.16	1
Anesthesiology	3,607	951	$32.98	7
Neurosurgery	3,314	330	$32.62	9
Neuropsychiatry	3,240	276	$33.43	5
Sleep Medicine	2,783	249	$31.82	2
Independent Diagnostic Testing Facility (IDTF)	2,276	255	$30.27	2
Orthopedic Surgery	2,103	245	$32.37	5
Otolaryngology	1,521	189	$31.81	1
Pediatric Medicine	1,396	473	$32.39	3
Diagnostic Radiology	1,066	75	$33.49	1
General Practice	1,060	395	$32.43	1
Psychiatry	974	408	$31.03	1

G0453 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.

State	Services	Allowed	Standardized pmt	Providers
California	70,698	$33.40	$24.60	65
Texas	43,377	$30.90	$24.67	50
New York	29,733	$35.13	$24.69	40
Florida	19,642	$32.29	$24.69	23
Georgia	18,990	$30.59	$24.54	15
Pennsylvania	15,766	$30.92	$24.68	26
Utah	14,217	$32.39	$24.61	6
Colorado	12,578	$30.75	$24.70	16
Illinois	10,527	$32.95	$24.73	27
Louisiana	10,281	$29.65	$24.70	11
New Jersey	8,903	$31.91	$24.68	13
Arizona	8,845	$30.36	$24.44	15
North Carolina	7,794	$30.20	$24.63	13
Tennessee	7,485	$32.26	$24.58	13
Maryland	7,479	$31.25	$24.71	19
Ohio	6,840	$29.79	$24.69	14
Wisconsin	6,516	$29.32	$24.71	7
Michigan	5,986	$30.32	$24.61	10
Minnesota	5,958	$30.98	$24.70	8
Massachusetts	5,455	$33.45	$24.68	6
Nevada	5,296	$30.81	$24.70	3
Virginia	4,649	$31.56	$24.72	5
Connecticut	4,604	$32.73	$24.71	4
Alaska	4,596	$37.95	$24.74	1
Kansas	3,912	$30.20	$24.71	4
Washington	3,592	$32.96	$24.65	12
Oregon	2,982	$32.15	$24.70	7
Puerto Rico	2,247	$32.03	$24.76	1
Arkansas	1,690	$28.85	$24.71	2
Oklahoma	1,544	$27.54	$24.50	1
South Carolina	1,217	$29.71	$24.75	3
Nebraska	1,106	$30.46	$24.74	1
Iowa	1,072	$29.20	$24.76	4
Missouri	967	$31.17	$24.73	2
Delaware	938	$31.05	$24.67	1
New Hampshire	833	$31.18	$24.72	3
Indiana	806	$29.64	$24.71	2
District of Columbia	777	$31.89	$24.48	2
Idaho	748	$29.23	$24.71	1
Rhode Island	391	$33.34	$24.79	1
New Mexico	380	$30.33	$24.60	1
Maine	305	$29.59	$24.70	1
Mississippi	127	$28.80	$24.77	2
AE	79	$31.55	$24.69	1

Related codes

G0439Annual wellness visit$117.95
G0444Annual depression screening$17.80
G0471Collection of venous blood by venipuncture or urine sample by catheter$10.56
G0442Annual alcohol misuse screening$17.96
G0480Drug test(s), definitive, utilizing (1) drug identification methods ab$110.33
G0483Drug test(s), definitive, utilizing (1) drug identification methods ab$240.71
G0482Drug test(s), definitive, utilizing (1) drug identification methods ab$193.45
G0481Drug test(s), definitive, utilizing (1) drug identification methods ab$152.51
G0438Annual wellness visit; includes a personalized prevention plan of serv$151.05
G0446Annual, face-to-face intensive behavioral therapy for cardiovascular d$24.56
G0447Face-to-face behavioral counseling for obesity$24.83
G0402Initial preventive physical examination; face-to-face visit$158.02

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.