What do doctors typically charge for Single Energy X-ray Absorptiometry Sexa Bone Density Study?

The nationwide median physician charge for Single Energy X-ray Absorptiometry Sexa Bone Density Study (HCPCS G0130) is $62.50. Doctor billed charges vary based on geographic region, setting, and overhead.

What is the standard insurance baseline for HCPCS G0130?

The standard insurance baseline reimbursement rate is $33.43. This represents the customary allowable amount established across standard fee schedules.

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HCPCS G0130Medical Service

Single Energy X-ray Absorptiometry Sexa Bone Density Study

Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel). Clinical pricing breakdown and utilization metrics across 6 practicing doctors nationwide.

$62.50

Peer Median Charge

Gross billed rate

$33.43

Standard Baseline

Customary allowable

1.9x

National Markup

Charge vs baseline

Active Physicians

Billing this code

Planning care or already received a bill for CPT G0130?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $62.50. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $33.43 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code G0130 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"