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See a sample rate comparisonHCPCS G8563 Fee Schedule
HCPCS G8563 is classified under Procedures / Professional Services, in the Additional Quality Measures subgroup.
Patient not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G8563 by major payers:
$71.01
BCBS / Anthem
$54.00
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G8563
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G8563 vs. Other Additional Quality Measures Codes
The table lists codes related to G8563. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G8562-HCPCS | Low | Patient does not have a history of active drainage from the ear within the previous 90 days |
| G8563-HCPCS | Low | Patient not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given |
| G8564-HCPCS | Low | Patient was referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not specified) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G8563. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G8563 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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