How much does Medicare pay for HCPCS G0498?

Medicare allowed an average of $177.57 per service and paid $140.58 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $801.21, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Which specialty bills G0498 most?

Hematology-Oncology, with 36,628 services from 630 clinicians. Next are Medical Oncology, Internal Medicine, Hematology.

HCPCS G0498

Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted l

$177.57Medicare-allowed amount per service, averaged across 51,103 services

Providers submitted

$801.21

Asking price, not received

Medicare allowed

$177.57

The fee schedule figure

Medicare paid

$140.58

Balance is patient coinsurance

Providers submitted an average of $801.21 for this code and Medicare allowed $177.57 — 4.5× 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 $140.58 (79%); the rest is the patient’s coinsurance and deductible.

Services: 51,103
Beneficiaries: 16,200
Providers billing it: 933
Total allowed: $9,074,360

What Medicare pays for HCPCS G0498

Across 51,103 services billed by 933 providers to 16,200 beneficiaries, Medicare allowed an average of $177.57 per service. That is 3.2 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 G0498

Specialty	Services	Beneficiaries	Avg allowed	Providers
Hematology-Oncology	36,628	10,964	$177.70	630
Medical Oncology	11,228	4,105	$178.44	235
Internal Medicine	1,350	554	$171.82	34
Hematology	1,227	285	$190.66	15
Gynecological Oncology	160	68	$144.52	5
Nurse Practitioner	154	27	$128.72	2
Physician Assistant	121	66	$146.82	4
Radiation Oncology	120	38	$142.99	3
Hematopoietic Cell Transplantation and Cellular Therapy	94	82	$157.90	4
Obstetrics & Gynecology	21	11	$153.67	1

G0498 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
Texas	7,884	$144.09	$114.03	162
Florida	7,576	$146.76	$112.72	120
Illinois	4,011	$255.64	$202.79	64
California	3,094	$194.23	$152.18	31
Virginia	2,703	$211.61	$168.46	61
Arizona	2,194	$167.17	$131.50	52
Tennessee	1,902	$190.23	$150.00	36
Kansas	1,604	$143.10	$112.91	17
New York	1,461	$265.89	$210.45	31
Alabama	1,435	$204.66	$163.51	22
Minnesota	1,286	$262.42	$198.94	48
Nevada	1,187	$177.90	$137.05	20
Iowa	1,046	$143.83	$113.42	15
Georgia	1,008	$213.66	$167.47	16
Colorado	955	$154.86	$122.99	23
Nebraska	939	$144.35	$114.48	16
Arkansas	930	$128.17	$102.57	13
Indiana	873	$149.84	$119.00	15
Maryland	820	$165.53	$130.45	11
Ohio	776	$165.64	$130.88	13
Pennsylvania	716	$157.41	$120.66	14
New Jersey	713	$169.36	$135.79	12
North Carolina	694	$208.01	$160.95	15
Missouri	692	$155.66	$123.11	20
Michigan	612	$161.26	$126.55	10
Mississippi	536	$135.53	$102.72	8
Oklahoma	530	$132.63	$105.36	11
Delaware	393	$156.13	$118.38	5
South Carolina	386	$219.92	$163.32	7
Oregon	355	$169.93	$127.44	11
South Dakota	326	$166.68	$132.58	3
Alaska	227	$194.40	$150.01	6
Washington	213	$172.27	$135.29	5
New Mexico	168	$131.81	$104.09	4
Wyoming	166	$175.88	$135.32	2
Maine	142	$258.70	$205.49	2
Utah	137	$160.13	$128.98	3
Wisconsin	132	$255.75	$201.17	3
New Hampshire	103	$274.57	$210.80	2
Vermont	97	$164.93	$131.41	1
West Virginia	47	$241.89	$180.52	1
Rhode Island	17	$184.15	$146.72	1
Kentucky	17	$247.20	$196.96	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
G0453Continuous intraoperative neurophysiology monitoring$32.00
G0446Annual, face-to-face intensive behavioral therapy for cardiovascular d$24.56
G0447Face-to-face behavioral counseling for obesity$24.83

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.