G0460
No office rateAutolog prp not diab ulcer
G0460 covers PRP or another blood-derived product for non-diabetic chronic wounds or ulcers; G0465 is for diabetic chronic wounds or ulcers.
On this page
CMS RVU26D · Effective 2026-10-01
G0465 Wound PRP Medicare reimbursement rates in Iowa
Reports preparation and application of a patient’s platelet-rich plasma with an FDA-cleared device to treat a diabetic chronic wound or ulcer. Compare G0465 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for G0465 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$975.55
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$79.17
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Wound care
About G0465: Autologous PRP treatment for diabetic ulcer
Reports preparation and application of a patient’s platelet-rich plasma with an FDA-cleared device to treat a diabetic chronic wound or ulcer.
G0465 describes a treatment in which the patient’s blood is processed with an FDA-cleared device to produce platelet-rich plasma or another blood-derived product, which is then applied to a diabetic chronic wound or ulcer. It is used in wound-care settings by clinicians treating chronic diabetic ulcers, including physicians and podiatrists. The code covers preparation and application as one treatment; it is not selected by wound area or billed separately for each step.
Report the service for a treatment of a diabetic chronic wound or ulcer, with documentation identifying the wound, its diabetic context, the device and blood-derived product used, and the application performed. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When performed in the same session with other procedures subject to the multiple procedure rule, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for G0465
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.78 · 6%
- Practice expense (office) RVU29.91 · 94%
- Malpractice RVU0.15 · 0%
1.5K
Medicare services in 2024 · #2693 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
G0465 compared with similar codes
Office rates for Iowa, from the same CMS release.
0232T
No office rateNjx platelet plasma
0232T describes PRP injection for other indications. G0465 covers preparation and application of PRP or another blood-derived product to a diabetic chronic wound or ulcer.
$145.07
15271 reports skin substitute graft application to trunk, arms, or legs. G0465 reports a blood-derived product treatment, not graft application.
Compare G0465 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
$975.55
Facility
$79.17
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for G0465 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
15,280
- Code
- G0465
- Physician work
- 1.78
- Practice expense
- 29.91
- Malpractice
- 0.15
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.78 | × 1.000 | 1.7800 |
| Practice expense | 29.91 | × 0.915 | 27.3677 |
| Malpractice | 0.15 | × 0.397 | 0.0595 |
| Total RVUs | 29.2072 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$975.55
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.78 | 1 |
| Practice expense | 29.91 | 0.915 |
| Malpractice | 0.15 | 0.397 |
(1.78 × 1 + 29.91 × 0.915 + 0.15 × 0.397) × $33.4009 = $975.55
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.78 | 1 |
| Practice expense | 0.58 | 0.915 |
| Malpractice | 0.15 | 0.397 |
(1.78 × 1 + 0.58 × 0.915 + 0.15 × 0.397) × $33.4009 = $79.17
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
G0465 billing questions
When should G0465 be chosen instead of G0460?
G0465 is for autologous PRP or another blood-derived product applied to a diabetic chronic wound or ulcer. G0460 is for the corresponding treatment of a non-diabetic chronic wound or ulcer.
Is the code reported per wound or by wound area?
G0465 is reported per treatment, not per square centimeter. The code includes preparation and application of the blood-derived product.
Can blood processing and PRP application be billed separately?
No. Preparation of the product using the FDA-cleared device and its application are included in G0465.
Does G0465 have a postoperative period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for G0465.
How is G0465 paid when other procedures occur in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other affected procedures are paid at 50%. Co-surgeons and team surgery are not permitted for G0465.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
15,277G0459,,Telehealth inpt pharm mgmt,A,,0.95,0.18,NA,0.18,,0.06,1.19,1.19,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,278G0460,,Autolog prp not diab ulcer,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,279G0463,,Hospital outpt clinic visit,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,280G0465,,Autolog prp diab wound ulcer,A,,1.78,29.91,,0.58,,0.15,31.84,2.51,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,281G0466,,Fqhc visit new patient,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,282G0467,,"Fqhc visit, estab pt",X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,283G0468,,"Fqhc visit, ippe or awv",X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136