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Cost Guide G0012 · HCPCS Level II

How much does Injection of HIV prevention medication cost?

Medicare pays $15.

By Michael Glenn , Healthcare Data Analyst · ·
Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.
About the analyst

Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.

3 care settings compared
CMS Medicare benchmark data
Updated 2026-04-03
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Medicare rateAverage chargeHigh end$0$78
$71
Above average
Average hospital charge vs. benchmarks: $15 (Medicare rate) · $71 (Average charge)
$15
Medicare rate
$71
Avg hospital charge
$56
Price spread
Rate comparison — Injection of HIV prevention medication
Medicare facility$15Hospital outpatient$71Avg chargemaster$71Non-facility$99$84 difference between lowest and highest rate
Research suggests 49–80% of hospital bills contain errors. Our system checks every line item against Medicare benchmarks.

Cost by care setting

Setting Medicare rate
Hospital outpatient (facility) $15
Physician office (non-facility) $99
Hospital outpatient (APC) $71

What affects the cost?

How to save on Injection of HIV prevention medication

  • 1 Request a detailed cost estimate in writing before any procedure
  • 2 Compare prices at multiple facilities — costs can vary 5–10x for the same procedure
  • 3 Ask about cash-pay discounts (often 30–60% off chargemaster rates)
  • 4 After receiving a bill, compare each line item against Medicare benchmark rates
Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

FAQ — Injection of HIV prevention medication cost

What is a fair price for Injection of hiv prep drug?
Medicare pays $15 for Injection of hiv prep drug (G0012). This is the government benchmark rate. A fair price for commercially insured or cash-pay patients is typically 1.2–2.5x the Medicare rate, or roughly $18–$38.
How can I lower my cost for Injection of hiv prep drug?
To lower your cost: (1) Compare prices at multiple facilities — use the comparison data on this page. (2) Ask about ASC (surgery center) options, which are often 40–60% cheaper. (3) Request cash-pay pricing upfront. (4) After receiving a bill, review each line item against Medicare benchmarks. Research suggests 49–80% of hospital bills contain errors.

Related pricing data

Injection of HIV prevention medication — Medicare rate detailsFull Medicare rate breakdown by setting and locality
More HCPCS Level II procedure costs

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Data: Federal physician fee schedules, hospital payment data, surgery center rates, lab fee schedules, and drug pricing data. FY 2024. All publicly available from federal sources.

Methodology: Rates shown are national Medicare reimbursement rates by care setting. Price ranges reflect variation across hospitals reporting the same procedure code. Metro prices are averaged from hospital-level chargemaster data reported to CMS.

This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use

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