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HCPCS G0245Medical Service

Initial Physician Evaluation and Management of a Diabetic Patient with Diabetic Sensory Neuropathy Resulting in a Loss of Protective Sensation Lops Which Must Include 1 the Diagnosis of Lops

Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that cons. Clinical pricing breakdown and utilization metrics across 10 practicing doctors nationwide.

$113.54
Peer Median Charge
Gross billed rate
$55.82
Standard Baseline
Customary allowable
2.0x
National Markup
Charge vs baseline
10
Active Physicians
Billing this code
Planning care or already received a bill for CPT G0245?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $113.54. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $55.82 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 G0245 if paid upfront?"
  • "Are there separate facility, anesthesia, or pathology fees associated with this procedure?"