No office rate
Use G0414 when open treatment addresses both anterior and posterior pelvic ring components; G0413 is for the anterior ring.
On this page
CMS RVU26D · Effective 2026-10-01
G0413 Pelvic ring repair Medicare reimbursement rates in Missouri
Reports open operative repair of an anterior pelvic ring fracture, such as a disruption involving the pubic symphysis or pubic rami, with fixation when performed. Compare G0413 office and facility rates across CMS payment localities in Missouri.
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 G0413 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$925.92–$961.07
3 of 3 localities have a supported rate.
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.
Where G0413 pays more and less in Missouri
Orthopedic surgery
About G0413: Open treatment of anterior pelvic ring fracture
Reports open operative repair of an anterior pelvic ring fracture, such as a disruption involving the pubic symphysis or pubic rami, with fixation when performed.
G0413 describes open surgery to repair a fracture disrupting the anterior pelvic ring, including injuries involving the pubic symphysis or pubic rami. An orthopedic trauma surgeon typically performs the operation in a hospital operating room, reducing the fracture and stabilizing it; internal fixation is included when used. The code encompasses unilateral or bilateral anterior-ring involvement, so the number of sides does not create a separate bilateral service.
Select G0413 when the operative report supports open treatment of the anterior ring. Document the fracture location, open approach, structures treated, and fixation performed. The code has a 90-day global period, including the day before surgery and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not. Modifier 50 is inappropriate because the code already encompasses unilateral or bilateral treatment.
CMS billing rules for G0413
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.34 · 52%
- Practice expense (office) RVU10.68 · 36%
- Malpractice RVU3.26 · 11%
2K
Medicare services in 2024 · #2460 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.
G0413 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
G0415 addresses open treatment of a posterior pelvic ring fracture, rather than the anterior-ring injury reported with G0413.
No office rate
G0412 concerns open treatment of iliac spine, tuberosity, or avulsion injuries; it is not the code for an anterior pelvic ring fracture.
Compare G0413 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$953.71
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$961.07
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$925.92
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G0413 billing questions
How does G0413 differ from G0414?
G0413 is for open treatment of the anterior pelvic ring. G0414 applies when both the anterior and posterior rings are treated.
Can G0413 be reported with modifier 50?
No. The code covers unilateral or bilateral anterior-ring treatment, and CMS specifies that bilateral adjustment does not apply.
Is internal fixation separately reported?
Internal fixation performed as part of the open fracture treatment is included in G0413.
What documentation supports G0413?
The operative report should identify the anterior-ring fracture site, the open treatment performed, and any fixation used. It should distinguish the treated anatomy from posterior-ring treatment.
How does the 90-day global affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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.
15,239G0410,,Grp psych php/iop 45-50,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
15,240G0411,,Interactive grp psyc php/iop,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
15,241G0412,,Open tx iliac spine uni/bil,A,,10.19,7.67,NA,7.67,,2.17,20.03,20.03,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,242G0413,,Pelvic ring fracture uni/bil,A,,15.34,10.68,NA,10.68,,3.26,29.28,29.28,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,243G0414,,Pelvic ring fx treat int fix,A,,14.28,10.35,NA,10.35,,3.04,27.67,27.67,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,244G0415,,Open tx post pelvic fxcture,A,,20.41,12.26,NA,12.26,,4.43,37.10,37.10,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,245G0416,,"Prostate biopsy, any mthd",A,,3.51,7.06,,7.06,NA,0.11,10.68,10.68,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00