Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS G0538 Fee Schedule
Medicare rates as of October 2026
HCPCS G0538 is classified under Procedures / Professional Services, in the Other Services subgroup.
Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Other Services |
| Complexity Level | Low |
| Medicare Fee Schedule | $17.03 national non-facility rate (2026) · View Medicare rates for G0538 |
| Medicaid Fee Schedule | $12.52 median of the 8 states in the free preview · View Medicaid rates for G0538 |
National average reimbursement for HCPCS G0538 by major payers:
$20.21
BCBS / Anthem
$21.30
UnitedHealthcare
$15.76
Aetna
$73.26
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0538.
HCPCS G0538
5 of 25 sample ratesHigher to lower in this preview
Piedmont Newton Hospital, Inc., Newton Medical Center
Piedmont Newton Hospital Inc
$48.15Published rateSt. Francis Radiologists, LLC
$28.65Published rateProfessional Resources Management Of Rabun, LLC, Mountain Lakes Medical Center
$23.88Published rateScottish Rite Childrens Medical Ctr, Children'S Healthcare Of Atlanta At Scottish Rite
Childrens Healthcare Of Atlanta Inc
$21.94Published rateMeriwether County Hospital Authority, Warm Springs Medical Center
Meriwether Healthcare, LLC D/B/A Warm Springs Medical Center
$16.94Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS G0538 vs. Other Other Services Codes
| Code | Complexity | Description |
|---|---|---|
| G0538-HCPCS | Low | Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0538. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0538 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS G0538) and we'll show you how you compare in 15 minutes or less.