HCPCS G0455

Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen

Current code30 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for HCPCS G0455 by hospital
Hospital	Medicaid managed care rates (lowest – highest)	Cash price	List price (before discounts)
EvergreenHealth Medical CenterKirkland	—	$2,276	$2,845
Harborview Medical CenterSeattleFile dated 2026-04-01	—	$760 – $1,677	$1,086 – $2,395
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01	—	$239	$368
Seattle Children's HospitalSeattle	$2,379 – $3,00812 plans	$9,254	$9,254
University of Washington Medical CtrSeattleFile dated 2026-04-01	—	$882 – $1,744	$1,261 – $2,492
Virginia Mason Medical CenterSeattle	—	$1,292	$2,534

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Doctor's fee, Seattle (King County): $170 in an office; $65.75 in a hospital or surgery center
Doctor's fee, rest of Washington: $151 in an office; $61.60 in a hospital or surgery center
Hospital outpatient payment (national): $950 (APC 5311)