How much does Medicare pay for HCPCS G0500?

Medicare allowed an average of $7.46 per service and paid $5.68 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $116.29, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does G0500 pay differently in an office than a hospital?

Yes. The allowed amount averaged $23.66 in an office setting and $5.41 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 G0500 most?

Gastroenterology, with 183,189 services from 1,984 clinicians. Next are Internal Medicine, General Surgery, Colorectal Surgery (Proctology).

HCPCS G0500

Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito

$7.46Medicare-allowed amount per service, averaged across 214,682 services

Providers submitted

$116.29

Asking price, not received

Medicare allowed

$7.46

The fee schedule figure

Medicare paid

$5.68

Balance is patient coinsurance

Providers submitted an average of $116.29 for this code and Medicare allowed $7.46 — 15.6× 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 $5.68 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $23.66
Hospital / facility: $5.41

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. 24,043 services were billed in an office setting and 190,639 in a facility.

Services: 214,682
Beneficiaries: 206,479
Providers billing it: 2,575
Total allowed: $1,601,528

What Medicare pays for HCPCS G0500

Across 214,682 services billed by 2,575 providers to 206,479 beneficiaries, Medicare allowed an average of $7.46 per service. 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 G0500

Specialty	Services	Beneficiaries	Avg allowed	Providers
Gastroenterology	183,189	176,452	$7.11	1,984
Internal Medicine	9,740	9,313	$7.86	125
General Surgery	9,141	8,883	$6.78	190
Colorectal Surgery (Proctology)	5,856	5,793	$7.92	124
Family Practice	1,743	1,636	$26.05	29
Cardiology	681	644	$5.40	18
Physical Medicine and Rehabilitation	665	518	$6.65	10
Hospitalist	503	478	$16.91	6
Diagnostic Radiology	394	370	$9.00	15
Interventional Cardiology	364	333	$5.56	10
General Practice	355	340	$42.81	4
Pain Management	320	261	$25.71	9
Interventional Radiology	281	269	$5.65	10
Thoracic Surgery	264	234	$5.16	7
Pulmonary Disease	252	248	$16.98	12

G0500 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	54,777	$8.41	$6.25	507
New York	13,644	$10.05	$8.20	189
Iowa	12,225	$4.90	$4.27	77
Massachusetts	11,488	$5.73	$4.23	202
Minnesota	11,150	$8.76	$6.84	173
Washington	10,292	$5.48	$4.34	113
Illinois	10,213	$7.62	$5.43	136
Ohio	8,595	$5.47	$4.26	188
Indiana	8,034	$4.98	$4.04	77
Wisconsin	6,842	$6.03	$5.13	77
Idaho	5,877	$5.07	$4.54	28
Michigan	3,976	$10.22	$8.58	67
Missouri	3,914	$6.22	$4.84	34
Vermont	3,719	$5.83	$4.55	38
Colorado	3,718	$5.91	$4.45	64
North Carolina	3,603	$6.10	$4.84	22
Arizona	3,504	$5.45	$3.94	37
Texas	3,322	$5.67	$4.43	36
New Mexico	3,053	$5.73	$4.19	22
New Hampshire	3,045	$5.50	$4.10	33
Florida	2,500	$7.46	$5.15	42
Rhode Island	2,293	$5.54	$3.91	35
Maine	2,152	$5.42	$4.11	25
Oregon	2,112	$5.46	$4.29	48
Utah	1,978	$5.42	$3.86	21
Puerto Rico	1,850	$51.94	$41.46	68
Pennsylvania	1,849	$5.62	$3.90	21
Alaska	1,714	$7.01	$4.23	10
Louisiana	1,655	$5.36	$4.18	15
Virginia	1,486	$15.17	$10.85	19
New Jersey	1,350	$8.64	$6.31	11
Arkansas	1,177	$4.93	$4.05	21
North Dakota	816	$5.09	$4.62	15
Georgia	781	$5.62	$4.16	7
West Virginia	779	$9.26	$7.05	8
Maryland	687	$5.34	$4.56	5
Nevada	659	$10.73	$7.67	10
Kentucky	609	$5.45	$3.95	6
Oklahoma	591	$5.34	$4.13	14
Hawaii	409	$5.28	$4.22	6
Connecticut	379	$5.81	$4.03	5
South Carolina	346	$5.49	$3.88	5
Kansas	316	$5.08	$4.32	7
South Dakota	261	$10.21	$10.01	8
Alabama	255	$4.95	$4.17	1
Montana	235	$13.38	$9.82	6
Tennessee	218	$11.16	$8.64	6
Mississippi	102	$5.18	$4.19	3
District of Columbia	67	$5.69	$4.44	2
Nebraska	65	$4.85	$3.73	5

Related codes

G0506Comprehensive assessment of and care planning for patients requiring c$54.10
G0513Prolonged preventive service(s) (beyond the typical service time of th$61.53
G0508Telehealth consultation$205.18
G0523Management of a new patient$395.12
G0509Telehealth consultation$186.15
G0522Management of a new patient$235.00
G0520Management of new patient-caregiver dyad$274.70
G0514Prolonged preventive service(s) (beyond the typical service time of th$61.07
G0519Management of new patient-caregiver dyad$148.71

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.