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See a sample rate comparisonHCPCS G2138 Fee Schedule
HCPCS G2138 is classified under Procedures / Professional Services, in the Functional Status subgroup.
Back pain as measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively was less than or equal to 3.0 or back pain measured by the visual analog scale (vas) or numeric pain scale within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated an improvement of 5.0 points or greater
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Functional Status |
| Complexity Level | Low |
National average reimbursement for HCPCS G2138 by major payers:
$71.25
BCBS / Anthem
$N/A
UnitedHealthcare
$0.01
Aetna
$0.00
Cigna
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HCPCS G2138
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G2138 vs. Other Functional Status Codes
The table lists codes related to G2138. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G2137-HCPCS | Low | Back pain measured by the visual analog scale (vas) or numeric pain scale at three months (6 - 20 weeks) postoperatively was greater than 3.0 and back pain measured by the visual analog scale (vas) or numeric pain scale within three months preoperatively and at three months (6 - 20 weeks) postoperatively demonstrated improvement of less than 5.0 points |
| G2138-HCPCS | Low | Back pain as measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively was less than or equal to 3.0 or back pain measured by the visual analog scale (vas) or numeric pain scale within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated an improvement of 5.0 points or greater |
| G2139-HCPCS | Low | Back pain measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively was greater than 3.0 and back pain measured by the visual analog scale (vas) or numeric pain scale within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated improvement of less than 5.0 points |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G2138. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G2138 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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