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See a sample rate comparisonHCPCS G8946 Fee Schedule
HCPCS G8946 is classified under Procedures / Professional Services, in the More Quality Measures subgroup.
Minimally invasive biopsy method attempted but not diagnostic of breast cancer (e.g., high risk lesion of breast such as atypical ductal hyperplasia, lobular neoplasia, atypical lobular hyperplasia, lobular carcinoma in situ, atypical columnar hyperplasia, flat epithelial atypia, radial scar, complex sclerosing lesion, papillary lesion, or any lesion with spindle cells)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services More Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G8946 by major payers:
$71.05
BCBS / Anthem
$54.00
UnitedHealthcare
$0.01
Aetna
$1.35
Cigna
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HCPCS G8946
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G8946 vs. Other More Quality Measures Codes
The table lists codes related to G8946. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G8944-HCPCS | Low | AJCC melanoma cancer Stage 0 through IIC melanoma |
| G8946-HCPCS | Low | Minimally invasive biopsy method attempted but not diagnostic of breast cancer (e.g., high risk lesion of breast such as atypical ductal hyperplasia, lobular neoplasia, atypical lobular hyperplasia, lobular carcinoma in situ, atypical columnar hyperplasia, flat epithelial atypia, radial scar, complex sclerosing lesion, papillary lesion, or any lesion with spindle cells) |
| G8950-HCPCS | Low | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G8946. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G8946 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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