G0416 Prostate biopsy, any mthd
Also known as: prostate biopsy, needle biopsy prostate, TRUS biopsy
Prostate tissue sampling by needle biopsy using any approach (transrectal, transperineal, or transurethral) for diagnostic evaluation.
In Plain Language
prostate tissue sample; prostate cancer test
Clinical Context
Used for diagnosis of elevated prostate specific antigen or suspicious findings. Multiple cores obtained to assess for malignancy.
RVU Breakdown
| Work RVU | 3.51 |
| Total RVU | 3.51 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
G-codes are CMS-specific HCPCS codes for services not covered by standard CPT. Documentation requirements follow the same standards as the equivalent CPT service. Check Medicare LCD/NCD policies for coverage criteria.
How This Code Compares
With a work RVU of 3.51, this code ranks in the 91st percentile among G Codes codes — 3.6x the median (0.97). The highest wRVU in this category is 20.41.
Specialties
Frequently Asked Questions
What is CPT code G0416?
CPT G0416 (Prostate biopsy, any mthd) is a G Codes code. Prostate tissue sampling by needle biopsy using any approach (transrectal, transperineal, or transurethral) for diagnostic evaluation.
Who uses CPT code G0416?
CPT G0416 is used by Urology, Oncology, Pathology. Used for diagnosis of elevated prostate specific antigen or suspicious findings. Multiple cores obtained to assess for malignancy.
When is CPT G0416 used?
Used for diagnosis of elevated prostate specific antigen or suspicious findings. Multiple cores obtained to assess for malignancy.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.