$194.19
G0517 describes removing a drug-delivery implant. Use G0516 for insertion of four or more implants, not removal alone.
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CMS RVU26D · Effective 2026-10-01
G0516 Drug implant insertion Medicare reimbursement rates in Vermont
Reports insertion of four or more drug-delivery implants, such as buprenorphine implant rods, during a single implantation procedure. Compare G0516 office and facility rates across CMS payment localities in Vermont.
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 G0516 in Vermont?
Vermont 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
$171.44
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$82.16
1 of 1 localities have a supported rate.
Payment area: Vermont
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.
Implant procedure
About G0516: Insertion of four or more drug implants
Reports insertion of four or more drug-delivery implants, such as buprenorphine implant rods, during a single implantation procedure.
G0516 describes placing four or more drug-delivery implants beneath the skin. A familiar example is insertion of buprenorphine implant rods in the upper arm for maintenance treatment of opioid use disorder. The procedure is performed by a qualified clinician in an office or other appropriate setting; the site and number of implants distinguish it from insertion of a single implant or management of implants already in place.
Report G0516 for the insertion procedure when four or more implants are placed. The record should identify the medication or implant, the body site, the number inserted, and the clinical purpose. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for G0516
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.77 · 34%
- Practice expense (office) RVU3.32 · 63%
- Malpractice RVU0.15 · 3%
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.
G0516 compared with similar codes
Office rates for Vermont, from the same CMS release.
$308.29
G0518 describes removing an implant and inserting a replacement. G0516 describes insertion of four or more implants without that removal-and-replacement service.
$103.45
CPT 11981 describes insertion of a non-biodegradable drug-delivery implant. Choose the code that matches the applicable service and implant-count criteria; G0516 specifies four or more implants.
Compare G0516 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
Vermont →
Office / nonfacility
$171.44
Facility
$82.16
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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 G0516 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
15,311
- Code
- G0516
- Physician work
- 1.77
- Practice expense
- 3.32
- Malpractice
- 0.15
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.77 | × 1.000 | 1.7700 |
| Practice expense | 3.32 | × 0.990 | 3.2868 |
| Malpractice | 0.15 | × 0.506 | 0.0759 |
| Total RVUs | 5.1327 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$171.44
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.77 | 1 |
| Practice expense | 3.32 | 0.99 |
| Malpractice | 0.15 | 0.506 |
(1.77 × 1 + 3.32 × 0.99 + 0.15 × 0.506) × $33.4009 = $171.44
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.77 | 1 |
| Practice expense | 0.62 | 0.99 |
| Malpractice | 0.15 | 0.506 |
(1.77 × 1 + 0.62 × 0.99 + 0.15 × 0.506) × $33.4009 = $82.16
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.
G0516 billing questions
When should G0516 be selected instead of a code for one implant?
Use G0516 when four or more drug-delivery implants are inserted in the procedure. A single-implant insertion is a different service and should not be reported as G0516.
Does G0516 include removal of existing implants?
G0516 represents insertion. G0517 describes removal, while G0518 describes removal with insertion of a replacement implant.
What documentation supports reporting G0516?
Document the implant or medication, insertion site, number of implants placed, and clinical purpose. The record should make clear that four or more implants were inserted.
Can modifier 50 be used for implants placed on both sides?
No. The CMS bilateral adjustment does not apply to G0516, and modifier 50 is inappropriate for this descriptor.
Can an assistant-at-surgery be reported with G0516?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
Is same-day postoperative care separately included in the global period?
No. G0516 has a 0-day global period, and same-day preoperative and postoperative care is included in the procedure.
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.
15,308G0509,,Crit care telehea consult 50,A,,3.86,1.06,NA,1.06,,0.36,5.28,5.28,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,309G0513,,"Prolong prev svcs, first 30m",A,,1.17,0.70,,0.28,,0.07,1.94,1.52,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,310G0514,,"Prolong prev svcs, addl 30m",A,,1.17,0.70,,0.28,,0.07,1.94,1.52,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,311G0516,,"Insert drug del implant, >=4",A,,1.77,3.32,,0.62,,0.15,5.24,2.54,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,312G0517,,Remove drug implant,A,,2.05,3.71,,0.68,,0.18,5.94,2.91,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,313G0518,,Remove w insert drug implant,A,,3.46,5.68,,0.98,,0.29,9.43,4.73,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,314G0519,,New pt-cg dyad dem low cmplx,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
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817