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See a sample rate comparisonHCPCS G0559 Fee Schedule
Medicare rates as of October 2026
HCPCS G0559 is classified under Procedures / Professional Services, in the Other Services subgroup.
Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a different specialty than the practitioner who performed the procedure, within the 90-day global period of the procedure(s), once per 90-day global period, when there has not been a formal transfer of care and requires the following required elements, when possible and applicable: reading available surgical note to understand the relative success of the procedure, the anatomy that was affected, and potential complications that could have arisen due to the unique circumstances of the patient's operation. research the procedure to determine expected post-operative course and potential complications (in the case of doing a post-op for a procedure outside the specialty). evaluate and physically examine the patient to determine whether the post-operative course is progressing appropriately. communicate with the practitioner who performed the procedure if any questions or concerns arise. (list separately in addition to office/outpatient evaluation and management visit, new or established)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Other Services |
| Complexity Level | Low |
| Medicare Fee Schedule | $9.69 national non-facility rate (2026) · View Medicare rates for G0559 |
| Medicaid Fee Schedule | $7.61 median of the 7 states in the free preview · View Medicaid rates for G0559 |
National average reimbursement for HCPCS G0559 by major payers:
$12.67
BCBS / Anthem
$9.11
UnitedHealthcare
$9.86
Aetna
$10.11
Cigna
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HCPCS G0559
5 of 25 sample ratesHigher to lower in this preview
Hospital Authority Of Jefferson County And The City Of Louisville, Jefferson Hospital
Hospital Authority Of Jefferson County And The City Of Louisville
$24.10Published rateHospital Authority Of Washington County, Washington County Regional Medical Center
$16.40Published rateThe Hospital Authority Of Miller County, Miller County Hospital - Pro Fees
The Hospital Authority Of Miller County
$12.61Published rateVictoria Lewis-Holland
$11.57Published rateMichael Koch
Chestatee Pathology Associates PC
$9.72Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0559 vs. Other Other Services Codes
| Code | Complexity | Description |
|---|---|---|
| G0559-HCPCS | Low | Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a different specialty than the practitioner who performed the procedure, within the 90-day global period of the procedure(s), once per 90-day global period, when there has not been a formal transfer of care and requires the following required elements, when possible and applicable: reading available surgical note to understand the relative success of the procedure, the anatomy that was affected, and potential complications that could have arisen due to the unique circumstances of the patient's operation. research the procedure to determine expected post-operative course and potential complications (in the case of doing a post-op for a procedure outside the specialty). evaluate and physically examine the patient to determine whether the post-operative course is progressing appropriately. communicate with the practitioner who performed the procedure if any questions or concerns arise. (list separately in addition to office/outpatient evaluation and management visit, new or established) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0559. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0559 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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