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See a sample rate comparisonHCPCS B4197 Fee Schedule
HCPCS B4197 is classified under Enteral and Parenteral Therapy, in the Parenteral Solutions and Supplies subgroup.
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix
| Key Fact | Detail |
|---|---|
| Service Type | Enteral and Parenteral Therapy Parenteral Solutions and Supplies |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | $331.93 median of the 8 states in the free preview · View Medicaid rates for B4197 |
National average reimbursement for HCPCS B4197 by major payers:
$305.56
BCBS / Anthem
$335.22
UnitedHealthcare
$313.36
Aetna
$314.92
Cigna
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HCPCS B4197
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$1,432.18Published ratePiedmont Newton Ekg Billing LLC
Piedmont Newton Hospital Inc
$578.88Published rateThe Hospital Authority Of Monroe County, Georgia, Monroe County Hospital
The Hospital Authority Of Monroe County Georgia
$442.08Published rateThe Hospital Authority Of Miller County, Miller County Hospital - Pro Fees
The Hospital Authority Of Miller County
$303.60Published rateChristopher Raio
Mercy Medical Center
$121.45Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS B4197 vs. Other Parenteral Solutions and Supplies Codes
The table lists codes related to B4197. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| B4193-HCPCS | Moderate | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix |
| B4197-HCPCS | Moderate | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix |
| B4199-HCPCS | Moderate | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS B4197. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the B4197 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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