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HCPCS G1028Medical Service

Take-home Supply of Nasal Naloxone

Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a standard insurance-enrolled opioid treatment program); list separately in addition to code for primary procedure. Clinical pricing breakdown and utilization metrics across 5 practicing doctors nationwide.

$150.00
Peer Median Charge
Gross billed rate
$125.29
Standard Baseline
Customary allowable
1.2x
National Markup
Charge vs baseline
5
Active Physicians
Billing this code
Planning care or already received a bill for CPT G1028?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 $150.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $125.29 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 G1028 if paid upfront?"
  • "Are there separate facility, anesthesia, or pathology fees associated with this procedure?"