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 G2174 Fee Schedule
HCPCS G2174 is classified under Procedures / Professional Services, in the Clinician Documentation and Management Services subgroup.
Uri episodes where the patient is taking antibiotics (table 1) in the 30 days prior to the episode date
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Clinician Documentation and Management Services |
| Complexity Level | Low |
National average reimbursement for HCPCS G2174 by major payers:
$71.25
BCBS / Anthem
$N/A
UnitedHealthcare
$49.42
Aetna
$0.00
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G2174.
HCPCS G2174
No sample rates available for this payer and code. Search provider rates to explore coverage.
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 G2174 vs. Other Clinician Documentation and Management Services Codes
The table lists codes related to G2174. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G2173-HCPCS | Low | Uri episodes where the patient had a comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease) |
| G2174-HCPCS | Low | Uri episodes where the patient is taking antibiotics (table 1) in the 30 days prior to the episode date |
| G2175-HCPCS | Low | Episodes where the patient had a comorbid condition during the 12 months prior to or on the episode date (e.g., tuberculosis, neutropenia, cystic fibrosis, chronic bronchitis, pulmonary edema, respiratory failure, rheumatoid lung disease) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G2174. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G2174 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 G2174) and we'll show you how you compare in 15 minutes or less.