G0465

CPT/HCPCS

Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other

Physician Fee Schedule

Facility

Medicare Payment

$97.79

Submitted Charge$853.25
Medicare Allowed$122.87
Providers39
Beneficiaries61
Total Services289
Office

Medicare Payment

$427.36

Submitted Charge$2,678.75
Medicare Allowed$535.56
Providers53
Beneficiaries92
Total Services356