HCPCS G0008 cost and Medicare rate

For code G0008, administration of influenza virus vaccine, Medicare's typical allowed amount nationally was about $29 in 2024, and providers typically billed about $41. Medicare rates are a common benchmark, not what every plan pays.

HCPCS G0008: Administration of influenza virus vaccine

Medicare 2024 allowed amounts, hospital outpatient rates July 2026, providers' billed amounts from 2024 · Checked 28 September 2026

What HCPCS G0008 is

Administration of influenza virus vaccine.

Code G0008 is paid under a different Medicare fee schedule (labs, ambulance, drugs and equipment have their own). The figures here are Medicare's typical allowed amounts from 2024; the hospital facility fee below is the July 2026 rate.

What Medicare pays for G0008 nationally

If it was done in a hospital

Medicare's national hospital outpatient (OPPS) rate for the hospital's own facility fee, before each hospital's local wage adjustment, which raises it in high-cost areas and lowers it in low-cost ones. The doctor bills separately under the fee schedule.

Medicare's July 2026 national rate for the hospital's facility fee for G0008 is $47.84 (payment group APC 5691).

For code G0008, administration of influenza virus vaccine, Medicare's 2026 national rate for the hospital's facility fee is about $48. The hospital and the doctor usually send separate bills. Medicare rates are a common benchmark, not what every plan pays.

G0008 by state

Where you were treated changes the benchmark. These are Medicare's typical allowed amounts in each state in 2024. Billed amounts are what providers typically billed in an office or clinic in 2024.

What your charge for G0008 means

Med Bill Check compares a charge with Medicare's rate and with what providers typically billed. Here is how it reads three national charges:

• Charged $30: Your $30 is close to the Medicare rate, which is a good sign. Medicare rates are a common benchmark, not what every plan pays.
• Charged $60: Your $60 is about 2.1 times the Medicare rate and 1.5 times what providers typically billed. That is a common benchmark rather than a verdict, and asking for an itemized bill or a self-pay discount is a sensible next step.
• Charged $120: Your $120 is about 4.1 times the Medicare rate and 2.9 times what providers typically billed. That is a common benchmark rather than a verdict, and asking for an itemized bill or a self-pay discount is a sensible next step.

Medicare rates are a common benchmark, not what every plan or provider charges, and never proof a bill is wrong. Enter your own charge and state on the home page for your figures.

Common billing questions for G0008

• Units: Medicare's automated limit for G0008 is 1 unit for one patient on one day (NCCI Medically Unlikely Edits). If your bill shows more, ask them to confirm the units. Medicare limits (MUE) are the most units Medicare pays automatically for one patient on one day. Going over is a reason to ask, not proof of an error, since some cases are allowed with records.
• Duplicates and services you did not get: Look for duplicate lines, services you did not receive, and unit counts that look high.
• Two bills: The hospital and the doctor usually send separate bills. Check which one each charge is on before comparing it with a rate.

How to question a charge for G0008

1. Ask for an itemized bill with codes, units and prices. Itemized bill letter.
2. Compare each line with your Explanation of Benefits if you have insurance.
3. Ask the billing office to review the charge in writing, and to hold the account from collections meanwhile. Charge review letter.
4. Ask for a prompt-pay or self-pay discount, or an interest-free payment plan. Discount letter.
5. If it was a hospital, ask for its financial assistance policy. Financial assistance letter and which hospitals must offer it.

With your code and amount, the review letter adds the benchmark for you, for example: For reference, Medicare's published 2024 data shows a typical allowed amount of about $29 for code G0008 in the US, and a typical billed amount of about $41.

Keep a copy of everything you send, and note the date and the name of anyone you speak to. If you have insurance, call your insurer too. They can check whether the claim was processed correctly.

Quick answers

What is HCPCS G0008?

Administration of influenza virus vaccine.

How much does Medicare pay for G0008?

Code G0008 is paid under a different Medicare fee schedule (labs, ambulance, drugs and equipment have their own). Medicare's typical allowed amount nationally was $29.10 in 2024. If it was done in a hospital, Medicare's July 2026 national rate for the hospital's facility fee is $47.84.

What do providers typically charge for G0008?

In 2024, providers nationally typically billed $40.77 for G0008 in an office or clinic.

Is $120 for G0008 too much?

Your $120 is about 4.1 times the Medicare rate and 2.9 times what providers typically billed. That is a common benchmark rather than a verdict, and asking for an itemized bill or a self-pay discount is a sensible next step.

How much is G0008 in Texas?

For code G0008, administration of influenza virus vaccine, Medicare's typical allowed amount in Texas was about $28 in 2024, and providers typically billed about $35. Medicare rates are a common benchmark, not what every plan pays.

How many units of G0008 can be billed in one day?

Medicare's automated limit is 1 for one patient on one day. Going over is a reason to ask, not proof of an error, since some cases are allowed with records.

Sources

• CMS Medicare Physician and Other Practitioners by Geography and Service, 2024 data (data.cms.gov)
• CMS Hospital Outpatient Prospective Payment System (OPPS) Addendum B, July 2026 (cms.gov), national unadjusted payment rates
• CMS NCCI Medically Unlikely Edits, effective 2026-10-01

General information, not medical, legal or financial advice. Medicare rates are a common benchmark, not what every plan or provider charges. For your own bill, check with the billing office, your insurer or your doctor.

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