Rate Benchmarking
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See a sample rate comparisonHCPCS G9061 Fee Schedule
HCPCS G9061 is classified under Procedures / Professional Services, in the Medicare Demonstration Projects subgroup.
Oncology; practice guidelines; patient's condition not addressed by available guidelines (for use in a Medicare-approved demonstration project)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Medicare Demonstration Projects |
| Complexity Level | Low |
National average reimbursement for HCPCS G9061 by major payers:
$52.22
BCBS / Anthem
$9.63
UnitedHealthcare
$0.24
Aetna
$6.72
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G9061.
HCPCS G9061
5 of 25 sample ratesHigher to lower in this preview
Arthur M. Blank Hospital, Inc., Arthur M. Blank Hospital
Childrens Healthcare Of Atlanta Inc
$24.77Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$15.31Published rateJulie Webster
Musc Community Physicians
$10.53Published rateTy Cobb Healthcare System, Cobb Memorial Hospital
Community Services Group Inc
$8.81Published rateMiguel Arenas
Miguel A Arenas Md PC
$6.15Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9061 vs. Other Medicare Demonstration Projects Codes
The table lists codes related to G9061. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9060-HCPCS | Low | Oncology; practice guidelines; management differs from guidelines for reason(s) associated with patient comorbid illness or performance status not factored into guidelines (for use in a Medicare-approved demonstration project) |
| G9061-HCPCS | Low | Oncology; practice guidelines; patient's condition not addressed by available guidelines (for use in a Medicare-approved demonstration project) |
| G9062-HCPCS | Low | Oncology; practice guidelines; management differs from guidelines for other reason(s) not listed (for use in a Medicare-approved demonstration project) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9061. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9061 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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