G0416 HCPCS Level II code: Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method
G0416 is the HCPCS code for “Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
G0416Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method
Short description: Prostate biopsy, any mthd
HCPCS · United States
Medicare details
The indicators CMS publishes with G0416 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Medicare pricing
- Physician fee schedule – Price established by carriers (e.g., not otherwise classified, individual determination, carrier discretion)
- Type of service
- Diagnostic laboratory
- BETOS category
- Lab tests - other (Medicare fee schedule)
- Lab certification
- Histopathology
- Added
- Jan 1, 2009
Where G0416 sits
- 1G codesProcedures and professional services
- 2Active code G0416Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code G0416 mean?
G0416 is the HCPCS code for “Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover G0416?
CMS lists G0416’s Medicare coverage as “Carrier judgment” and its pricing as “Physician fee schedule – Price established by carriers (e.g., not otherwise classified, individual determination, carrier discretion)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside G0416
All G codesG0410Group psychotherapy other than of a multiple-family group, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutesG0411Interactive group psychotherapy, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutesG0412Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring…G0413Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes…G0414Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when…G0415Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation…G0417Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 21-40 specimensG0418Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, 41-60 specimensG0419Surgical pathology, gross and microscopic examination, for prostate needle biopsy, any method, >60 specimensG0420Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hourG0421Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hourG0422Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session