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See a sample rate comparisonHCPCS G2176 Fee Schedule
HCPCS G2176 is classified under Procedures / Professional Services, in the Clinician Documentation and Management Services subgroup.
Outpatient, ed, or observation visits that result in an inpatient admission
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Clinician Documentation and Management Services |
| Complexity Level | Low |
National average reimbursement for HCPCS G2176 by major payers:
$71.25
BCBS / Anthem
$N/A
UnitedHealthcare
$49.42
Aetna
$0.00
Cigna
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HCPCS G2176
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G2176 vs. Other Clinician Documentation and Management Services Codes
The table lists codes related to G2176. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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) |
| G2176-HCPCS | Low | Outpatient, ed, or observation visits that result in an inpatient admission |
| G2177-HCPCS | Low | Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (table 1) in the 30 days prior to the episode date |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G2176. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G2176 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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