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HCPCS G0246Medical Service

Follow-up Physician Evaluation and Management of a Diabetic Patient with Diabetic Sensory Neuropathy Resulting in a Loss of Protective Sensation Lops to Include at Least the Following 1 a Patient History

Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a). Clinical pricing breakdown and utilization metrics across 64 practicing doctors nationwide.

$73.84
Peer Median Charge
Gross billed rate
$36.37
Standard Baseline
Customary allowable
2.0x
National Markup
Charge vs baseline
64
Active Physicians
Billing this code
Planning care or already received a bill for CPT G0246?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 $73.84. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $36.37 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 G0246 if paid upfront?"
  • "Are there separate facility, anesthesia, or pathology fees associated with this procedure?"