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See a sample rate comparisonHCPCS G9079 Fee Schedule
HCPCS G9079 is classified under Procedures / Professional Services, in the Medicare Demonstration Projects subgroup.
Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; T3B-T4, any N; any T, N1 at diagnosis 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 G9079 by major payers:
$59.00
BCBS / Anthem
$9.62
UnitedHealthcare
$0.25
Aetna
$8.55
Cigna
Compare published rates across providers.
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HCPCS G9079
5 of 25 sample ratesHigher to lower in this preview
Ujuka Iloabuchi
Gwinnett Obgyn Associates Of Georgia LLC
$19.98Published rateKevin Schlessel
$11.30Published rateGeorge Hemstreet
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$8.46Published rateMonroe Hma, LLC, Clearview Regional Medical Center
Monroe Hma LLC
$7.80Published 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 G9079 vs. Other Medicare Demonstration Projects Codes
The table lists codes related to G9079. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9078-HCPCS | Low | Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; T2 or T3A Gleason 8-10 or PSA > 20 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a Medicare-approved demonstration project) |
| G9079-HCPCS | Low | Oncology; disease status; prostate cancer, limited to adenocarcinoma as predominant cell type; T3B-T4, any N; any T, N1 at diagnosis with no evidence of disease progression, recurrence, or metastases (for use in a Medicare-approved demonstration project) |
| G9080-HCPCS | Low | Oncology; disease status; prostate cancer, limited to adenocarcinoma; after initial treatment with rising PSA or failure of PSA decline (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 G9079. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9079 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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