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See a sample rate comparisonHCPCS G9071 Fee Schedule
HCPCS G9071 is classified under Procedures / Professional Services, in the Medicare Demonstration Projects subgroup.
Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; Stage I or Stage IIA-IIB; or T3, N1, M0; and ER and/or pr positive; 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 G9071 by major payers:
$53.54
BCBS / Anthem
$9.62
UnitedHealthcare
$0.40
Aetna
$5.75
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G9071.
HCPCS G9071
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$27.04Published rateMichael Guillette
Aztec Urgent Care LLC
$13.94Published rateMiguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
$10.18Published rateDonalsonville Hospital Inc
$8.57Published rateDodge County Hospital Authority, Dodge County Hospital
Dodge County Hospital Authority
$7.65Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9071 vs. Other Medicare Demonstration Projects Codes
The table lists codes related to G9071. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9070-HCPCS | Low | Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small; extent of disease unknown, staging in progress, or not listed (for use in a Medicare-approved demonstration project) |
| G9071-HCPCS | Low | Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; Stage I or Stage IIA-IIB; or T3, N1, M0; and ER and/or pr positive; with no evidence of disease progression, recurrence, or metastases (for use in a Medicare-approved demonstration project) |
| G9072-HCPCS | Low | Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; Stage I, or Stage IIA-IIB; or T3, N1, M0; and ER and PR negative; with no evidence of disease progression, recurrence, or metastases (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 G9071. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9071 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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