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 G8864 Fee Schedule
HCPCS G8864 is classified under Procedures / Professional Services, in the More Quality Measures subgroup.
Pneumococcal vaccine administered or previously received
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services More Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G8864 by major payers:
$57.31
BCBS / Anthem
$54.00
UnitedHealthcare
$0.03
Aetna
$1.16
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G8864.
HCPCS G8864
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 G8864 vs. Other More Quality Measures Codes
The table lists codes related to G8864. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G8863-HCPCS | Low | Patients not assessed for risk of bone loss, reason not given |
| G8864-HCPCS | Low | Pneumococcal vaccine administered or previously received |
| G8865-HCPCS | Low | Documentation of medical reason(s) for not administering or previously receiving pneumococcal vaccine (e.g., patient allergic reaction, potential adverse drug reaction) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G8864. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G8864 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 G8864) and we'll show you how you compare in 15 minutes or less.