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See a sample rate comparisonHCPCS G9075 Fee Schedule
HCPCS G9075 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; M1 at diagnosis, metastatic, locally recurrent, or progressive (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 G9075 by major payers:
$56.64
BCBS / Anthem
$9.62
UnitedHealthcare
$0.40
Aetna
$5.46
Cigna
Compare published rates across providers.
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HCPCS G9075
5 of 25 sample ratesHigher to lower in this preview
Leigh Taylor
$22.78Published rateEmory University Hospital
Emory University
$16.17Published rateCarolina Radiology Associates LLC
Carolina Radiology Associates, LLC
$9.96Published rateJulie Webster
Musc Community Physicians
$8.43Published rateCindy Chang
Miguel A Arenas Md PC
$5.96Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9075 vs. Other Medicare Demonstration Projects Codes
The table lists codes related to G9075. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9074-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 PR negative; with no evidence of disease progression, recurrence, or metastases (for use in a Medicare-approved demonstration project) |
| G9075-HCPCS | Low | Oncology; disease status; invasive female breast cancer (does not include ductal carcinoma in situ); adenocarcinoma as predominant cell type; M1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a Medicare-approved demonstration project) |
| G9077-HCPCS | Low | Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; T1-T3C and gleason 2-7 and PSA < or equal to 20 at diagnosis 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 G9075. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9075 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.
FREE SAMPLE MARKET COMPARISON
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