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Current CMS pricing and breakdown for Hepb screen high risk indiv.
National Medicare Payment
$28.27
This fee schedule does not publish separate facility and non-facility rates for this code.
Effective Q3 2026
This item has a standard price nationwide. Your local rate will likely match the amount shown above.
| Quarter | National Medicare Payment | YoY % Change |
|---|---|---|
| 2026 Q3 | $28.27 | +0.00% |
| 2026 Q2 | $28.27 | +0.00% |
| 2026 Q1 | $28.27 | +0.00% |
| 2025 Q4 | $28.27 | — |
| 2025 Q3 | $28.27 | — |
| 2025 Q2 | $28.27 | — |
| 2025 Q1 | $28.27 | — |
Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result
CPT code G0499 (Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result) had a 2026 Medicare non-facility reimbursement rate of $28.27. This reflects a 0.00% change from the prior year.
The 2026 National Medicare reimbursement for G0499 is $28.27. This item is paid at a standard national rate, so local variation is typically minimal.
Description: Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepat.... Payment policies and coverage rules can still vary by setting and claim details, so confirm final guidance through CMS when needed.
| Component | Office (Non-Fac) | Facility (Hosp) |
|---|---|---|
| Work RVU | ||
| Practice Expense (PE) | ||
| Malpractice (MP) | ||
| Total RVUs | 0.00 | 0.00 |
Compare a payment against the Medicare benchmark for this code.
Medicare rates are used as a benchmark only. Actual payer contracts, modifiers, place of service, units, and billing rules may affect reimbursement. This tool is for educational and operational review purposes, not legal or billing advice.
Facility vs. non-facility pricing most commonly applies to physician services paid under the RVU-based Physician Fee Schedule. For G0499 (Clinical Laboratory Test), the payment methodology may not include both facility and non-facility rates.
Medicare reimbursement is determined by RVUs, geographic adjustments, and the annual conversion factor.
The 2026 National Average Medicare reimbursement rate for G0499 (Clinical Laboratory Test) is $28.27. This rate is effective as of January 1, 2026.
Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result
Facility vs. non-facility differences usually apply to RVU-based physician services. G0499 may not use both facility and non-facility pricing depending on its payment methodology.
Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool on the homepage to estimate your locality-adjusted reimbursement. Medicare payment can vary based on geographic adjustments (GPCI), place of service, and claim specifics.
Coverage depends on medical necessity, setting, and Medicare policy. Some codes may be bundled, contractor-priced, or restricted. Verify final coverage guidance through CMS or your local MAC when applicable.