G0516 — Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)
G0516 is a HCPCS Level II code for insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant). It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusA
Active code. Paid separately under the physician fee schedule.
- Work RVU
- 1.77
- PE (non-facility)
- 3.32
- PE (facility)
- 0.62
- Malpractice RVU
- 0.15
Global period: 000
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of G0516 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
- outpatient
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for G0516
- Long descriptor
- Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)
- Short descriptor
- Insert drug del implant, >=4
- Added
- January 1, 2018
- BETOS
- P6C
- Pricing indicator
- 13 — Physician fee schedule
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Price established by carriers — not otherwise classified, individual determination, or carrier discretion.
Codes adjacent to G0516
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G0516 is not quite right, the correct code is very often within a few positions of it.
- G0507Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care teamterminated
- G0508Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth
- G0509Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth
- G0511Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar monthterminated
- G0512Rural health clinic or federally qualified health center (rhc/fqhc) only, psychiatric collaborative care model (psychiatric cocm), 60 minutes or more of clinical staff time for psychiatric cocm services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm) and including services furnished by a behavioral health care manager and consultation with a psychiatric consultant, per calendar monthterminated
- G0513Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)
- G0514Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventive service)
- G0515Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutesterminated
- G0517Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
- G0518Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)
- G0519Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model
- G0520Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model
- G0521Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model
- G0522Management of a new patient with dementia, low complexity, for use in cmmi model
- G0523Management of a new patient with dementia, moderate to high complexity, for use in cmmi model
- G0524Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model
Questions about G0516
What is HCPCS code G0516?
G0516 is a HCPCS Level II code for insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant). It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G0516?
The CMS HCPCS file marks G0516 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is G0516 paid under the physician fee schedule?
G0516 carries PFS status code A. Active code. Paid separately under the physician fee schedule.