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See a sample rate comparisonHCPCS G9080 Fee Schedule
HCPCS G9080 is classified under Procedures / Professional Services, in the Medicare Demonstration Projects subgroup.
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)
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Medicare Demonstration Projects |
| Complexity Level | Low |
National average reimbursement for HCPCS G9080 by major payers:
$60.64
BCBS / Anthem
$9.62
UnitedHealthcare
$0.39
Aetna
$6.33
Cigna
Compare published rates across providers.
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HCPCS G9080
5 of 25 sample ratesHigher to lower in this preview
Scottish Rite Childrens Medical Ctr, Children'S Healthcare Of Atlanta At Scottish Rite
Childrens Healthcare Of Atlanta Inc
$24.73Published rateMichael Shuler
Athens Orthopedic Clinic, PA
$14.30Published rateTift Regional Health System, Inc., Southwell Medical
Tift Regional Health System Inc
$11.10Published rateJulie Webster
Carolina Radiology Associates, LLC
$9.96Published rateTexas Radiology Associates LLP
Texas Radiology Associates, LLP
$6.51Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9080 vs. Other Medicare Demonstration Projects Codes
The table lists codes related to G9080. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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) |
| G9083-HCPCS | Low | Oncology; disease status; prostate cancer, limited to adenocarcinoma; extent of disease unknown, staging in progress, or not listed (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 G9080. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9080 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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