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See a sample rate comparisonHCPCS G4009 Fee Schedule
HCPCS G4009 is classified under Procedures / Professional Services, in the MIPS Specialty Set subgroup.
Hospitalists mips specialty set
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services MIPS Specialty Set |
| Complexity Level | Low |
National average reimbursement for HCPCS G4009 by major payers:
$71.21
BCBS / Anthem
$N/A
UnitedHealthcare
$49.42
Aetna
$N/A
Cigna
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HCPCS G4009
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G4009 vs. Other MIPS Specialty Set Codes
The table lists codes related to G4009. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G4008-HCPCS | Low | Geriatrics mips specialty set |
| G4009-HCPCS | Low | Hospitalists mips specialty set |
| G4010-HCPCS | Low | Infectious disease mips specialty set |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G4009. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G4009 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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