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See a sample rate comparisonHCPCS G8709 Fee Schedule
HCPCS G8709 is classified under Procedures / Professional Services, in the More Quality Measures subgroup.
Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services More Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G8709 by major payers:
$61.58
BCBS / Anthem
$54.00
UnitedHealthcare
$0.03
Aetna
$3.97
Cigna
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HCPCS G8709
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G8709 vs. Other More Quality Measures Codes
The table lists codes related to G8709. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G8708-HCPCS | Low | Patient not prescribed antibiotic |
| G8709-HCPCS | Low | Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne) |
| G8710-HCPCS | Low | Patient prescribed antibiotic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G8709. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G8709 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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