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See a sample rate comparisonHCPCS G9068 Fee Schedule
HCPCS G9068 is classified under Procedures / Professional Services, in the Medicare Demonstration Projects subgroup.
Oncology; disease status; limited to small cell and combined small cell/non-small cell; extent of disease initially established as limited with no evidence of disease progression, recurrence, or metastases (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 G9068 by major payers:
$52.13
BCBS / Anthem
$9.62
UnitedHealthcare
$0.39
Aetna
$4.72
Cigna
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HCPCS G9068
5 of 25 sample ratesHigher to lower in this preview
Kamran Rajaee
$22.78Published rateChu Chen
$16.09Published rateJulie Webster
Musc Community Physicians
$10.52Published rateThe Medical Center Inc, Piedmont Columbus Regional Midtown
The Medical Center Inc
$8.43Published rateCarolina Radiology Associates LLC
Carolina Radiology Associates, LLC
$6.88Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9068 vs. Other Medicare Demonstration Projects Codes
The table lists codes related to G9068. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9067-HCPCS | Low | Oncology; disease status; limited to non-small cell lung cancer; extent of disease unknown, staging in progress, or not listed (for use in a Medicare-approved demonstration project) |
| G9068-HCPCS | Low | Oncology; disease status; limited to small cell and combined small cell/non-small cell; extent of disease initially established as limited with no evidence of disease progression, recurrence, or metastases (for use in a Medicare-approved demonstration project) |
| G9069-HCPCS | Low | Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small cell; extensive Stage at diagnosis, metastatic, locally recurrent, or progressive (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 G9068. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9068 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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