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See a sample rate comparisonHCPCS G0252 Fee Schedule
HCPCS G0252 is classified under Procedures / Professional Services, in the Miscellaneous Diagnostic and Therapeutic Services subgroup.
PET imaging, full and partial-ring PET scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Miscellaneous Diagnostic and Therapeutic Services |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | $116.55 median of the 5 states in the free preview · View Medicaid rates for G0252 |
National average reimbursement for HCPCS G0252 by major payers:
$395.13
BCBS / Anthem
$90.07
UnitedHealthcare
$1,334.70
Aetna
$569.69
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0252.
HCPCS G0252
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$281.42Published rateEvans Memorial Hospital, Inc.
Evans Memorial Hospital Inc
$137.05Published rateRedmond Park Hospital LLC, Redmond Hospital Based Services LLC
Redmond Park Hospital LLC
$95.97Published rateBradley Weisner
Urology Specialists Of The Carolinas, PLLC
$3.92Published rateEmory Crawford Long Hospital
Emory University
$0.01Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0252 vs. Other Miscellaneous Diagnostic and Therapeutic Services Codes
The table lists codes related to G0252. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G0250-HCPCS | Low | Physician review, interpretation, and patient management of home INR testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria; testing not occurring more frequently than once a week; billing units of service include 4 tests |
| G0252-HCPCS | Moderate | PET imaging, full and partial-ring PET scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes) |
| G0255-HCPCS | Low | Current perception threshold/sensory nerve conduction test, (SNCT) per limb, any nerve |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0252. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0252 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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