# HCPCS G0416: Surgical pathology, prostate needle biopsy, any method, 1-20 specimens

Medicare HCPCS G0416 pays $356.72 in a non-facility setting and $356.72 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $321.69 in Arkansas to $429.02 in Alaska, a 33% spread.

Web page: https://www.med-reveal.com/rates/G0416-hcpcs-fee-schedule
Section: Temporary, Administrative and Miscellaneous

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $356.72 |
| National facility | $356.72 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $429.02 | $429.02 |
| District of Columbia | $405.44 | $405.44 |
| California | $402.46 | $402.46 |
| New Jersey | $392.78 | $392.78 |
| Washington | $392.66 | $392.66 |
| New York | $390.86 | $390.86 |
| Massachusetts | $388.61 | $388.61 |
| Hawaii | $387.48 | $387.48 |
| Connecticut | $378.00 | $378.00 |
| Colorado | $372.42 | $372.42 |
| Oregon | $369.26 | $369.26 |
| Maryland | $368.55 | $368.55 |
| Rhode Island | $366.33 | $366.33 |
| New Hampshire | $365.93 | $365.93 |
| Florida | $360.99 | $360.99 |
| Minnesota | $360.97 | $360.97 |
| Puerto Rico | $359.26 | $359.26 |
| Virgin Islands | $359.26 | $359.26 |
| Montana | $356.71 | $356.71 |
| Nevada | $356.34 | $356.34 |
| Wyoming | $355.77 | $355.77 |
| North Dakota | $354.54 | $354.54 |
| South Dakota | $354.28 | $354.28 |
| Delaware | $354.11 | $354.11 |
| Texas | $353.45 | $353.45 |
| Pennsylvania | $353.20 | $353.20 |
| Vermont | $352.55 | $352.55 |
| Illinois | $352.52 | $352.52 |
| Virginia | $351.63 | $351.63 |
| Arizona | $348.88 | $348.88 |
| Georgia | $346.77 | $346.77 |
| Maine | $344.86 | $344.86 |
| Wisconsin | $344.28 | $344.28 |
| Michigan | $343.84 | $343.84 |
| Utah | $342.20 | $342.20 |
| North Carolina | $339.60 | $339.60 |
| South Carolina | $338.25 | $338.25 |
| New Mexico | $337.89 | $337.89 |
| Indiana | $337.62 | $337.62 |
| Missouri | $337.25 | $337.25 |
| Louisiana | $336.38 | $336.38 |
| Nebraska | $336.28 | $336.28 |
| Ohio | $336.24 | $336.24 |
| Idaho | $335.92 | $335.92 |
| Iowa | $334.46 | $334.46 |
| Tennessee | $333.56 | $333.56 |
| Kansas | $332.26 | $332.26 |
| Oklahoma | $330.67 | $330.67 |
| Kentucky | $330.23 | $330.23 |
| West Virginia | $327.41 | $327.41 |
| Alabama | $325.65 | $325.65 |
| Mississippi | $322.99 | $322.99 |
| Arkansas | $321.69 | $321.69 |

## Related codes

- G0068: Professional services for home infusion drug administration, IV push, per diem — https://www.med-reveal.com/rates/G0068-hcpcs-fee-schedule
- G0070: Professional services for home infusion, subcutaneous infusion, initial visit — https://www.med-reveal.com/rates/G0070-hcpcs-fee-schedule
- G0154: Direct skilled nursing services, home health, each 15 minutes — https://www.med-reveal.com/rates/G0154-hcpcs-fee-schedule
- G0179: Physician recertification for Medicare-covered home health services — https://www.med-reveal.com/rates/G0179-hcpcs-fee-schedule
- G0180: Physician certification for Medicare-covered home health services — https://www.med-reveal.com/rates/G0180-hcpcs-fee-schedule
- G0181: Physician supervision of home health patient, 30 minutes or more — https://www.med-reveal.com/rates/G0181-hcpcs-fee-schedule
- G0182: Physician supervision of hospice patient, 30 minutes or more — https://www.med-reveal.com/rates/G0182-hcpcs-fee-schedule
- G0248: Demonstration/training patient/caregiver for INR home monitoring — https://www.med-reveal.com/rates/G0248-hcpcs-fee-schedule

Commercial negotiated rates for G0416 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules