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See a sample rate comparisonHCPCS G9072 Fee Schedule
HCPCS G9072 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 PR negative; 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 G9072 by major payers:
$63.00
BCBS / Anthem
$9.62
UnitedHealthcare
$0.40
Aetna
$9.67
Cigna
Compare published rates across providers.
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HCPCS G9072
5 of 25 sample ratesHigher to lower in this preview
Piedmont Newton Ekg Billing LLC
Piedmont Newton Hospital Inc
$19.98Published rateJayne Bernier
Radiology Associates Of Clearwater, P.A.
$15.07Published ratePalmyra Park Hospital, Inc., Palmyra Medical Centers
$11.10Published rateChristopher Raio
Mercy Medical Center
$9.79Published 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 G9072 vs. Other Medicare Demonstration Projects Codes
The table lists codes related to G9072. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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) |
| G9073-HCPCS | Low | Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; Stage IIIA-IIIB; and not 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) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9072. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9072 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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