HCPCS G0269 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Procedures / Professional Services • Miscellaneous Diagnostic and Therapeutic Services |
| Complexity Level | High |
National average reimbursement for HCPCS G0269 by major payers:
$1,053.92
$107.29
$318.48
$7.76
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS G0269 | ||||||
United | G0269 | $490.00 | 1225031495 - MONROE SURGICAL HOSPITAL, LLC | 721479756 - (LA) MONROE SURGICAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | G0269 | $92.00 | 1780865634 - NEW ORLEANS LA UPTOWN WEST BANK ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND TERAPEUTIC CENTER | 205904604 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | G0269 | $79.00 | 1720262405 - BATON ROUGE LA ENDOSCOPY ASC LLC, LOUISIANA ENDOSCOPY CENTER | 261168310 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | G0269 | $2538.00 | 1386664779 - WELLSTAR SYLVAN GROVE HOSPITAL, INC, SYLVAN GROVE HOSPITAL | 810875069 - (GA) WELLSTAR SYLVAN GROVE HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | G0269 | $1265.00 | 1679664395 - SAINT JOSEPHS HOSPITAL OF ATLANTA INC | 580566257 - (GA) SAINT JOSEPHS HOSPITAL OF ATLANTA INC | GA | General Acute Care Hospital (282N00000X) |
United | G0269 | $1056.00 | 1285601088 - HOSPITAL SERVICE DISTRICT NO. 1 OF IBERIA PARISH, IBERIA MEDICAL CENTER | 726014963 | LA | General Acute Care Hospital (282N00000X) |
United | G0269 | $1200.00 | 1023018835 - WARDS 3 4 & 10 HOSPITAL SERVICE DISTRICT PARISH OF UNION, REEVES MEMORIAL MEDICAL CENTER | 720685207 | LA | Critical Access Hospital (282NC0060X) |
United | G0269 | $970.00 | 1629015573 - LSUMC UNIVERSITY MEDICAL CENTER | 462605366 - (LA) UNIVERSITY HOSPITAL & CLINICS INC | LA | General Acute Care Hospital (282N00000X) |
United | G0269 | $913.00 | 1538174347 - LCMC HEALTH HOLDINGS INC, EAST JEFFERSON GENERAL HOSPITAL | 621596506 | LA | General Acute Care Hospital (282N00000X) |
United | G0269 | $2500.00 | 1831209048 - OCHSNER MEDICAL CENTER- WESTBANK | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | G0269 | $959.00 | 1043218365 - HOSPITAL SERVICE DISTRICT NO. 1 OF THE PARISH OF ST. MARY, BAYOU BEND HEALTH SYSTEM | 726008504 - (LA) HOSPITAL SERVICE DISTRICT NO 1 OF THE PARISH OF ST MARY | LA | Critical Access Hospital (282NC0060X) |
United | G0269 | $318.00 | 1003925959 - HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA., HOOD MEMORIAL HOSPITAL | 720694946 - (LA) HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA | LA | Critical Access Hospital (282NC0060X) |
United | G0269 | $121.00 | 1669586376 - JEFFERSON AMBULATORY SURGERY CENTER LLC | 202349222 - (LA) JEFFERSON AMBULATORY SURGERY C | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | G0269 | $2538.00 | 1619997079 - WELLSTAR SYLVAN GROVE HOSPITAL, INC, WELLSTAR SYLVAN GROVE HOSPITAL | 810875069 - (GA) WELLSTAR SYLVAN GROVE HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | G0269 | $669.00 | 1972549855 - SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC, LAKE CHARLES MEMORIAL HOSPITAL | 720551963 - (LA) SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC | LA | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS G0269 vs. Other Miscellaneous Diagnostic and Therapeutic Services Codes
The HCPCS G0269 code is part of the Procedures / Professional Services services used for Miscellaneous Diagnostic and Therapeutic Services. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS G0269 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| G0268-HCPCS | Low | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing |
| G0269-HCPCS | High | Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) |
| G0270-HCPCS | Low | Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0269. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0269 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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