HCPCS G0413: Pelvic ring repairMedicare rate & RVUs in Washington
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.
CMS doesn’t publish an office rate for G0413 in Washington.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What G0413 covers
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.
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.
Where G0413 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $977.52 |
| Seattle (King Cnty) | Unavailable | $1,064.65 |
How the G0413 rate is calculated
Each of G0413’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · G0413
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 15.34Practice expense 10.68Malpractice 3.26
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for G0413
G0413 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · G0413
Pelvic ring repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · G0413
Pelvic ring repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
G0413 without 51 · national facility
$977.98
Pelvic ring repair
G0413-51 · Second procedure: 50%
$488.99
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
G0413 compared with similar codes
Compare codes
G0413 vs G0414 vs G0415 vs G0412: national Medicare rates
Swap in your local Medicare rate.
How to choose
- G0414Pelvic fracture repair
- Use G0414 when open treatment addresses both anterior and posterior pelvic ring components; G0413 is for the anterior ring.
- G0415Pelvic fracture repair
- G0415 addresses open treatment of a posterior pelvic ring fracture, rather than the anterior-ring injury reported with G0413.
- G0412Iliac spine repair
- G0412 concerns open treatment of iliac spine, tuberosity, or avulsion injuries; it is not the code for an anterior pelvic ring fracture.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put G0413 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →