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See a sample rate comparisonHCPCS G9091 Fee Schedule
HCPCS G9091 is classified under Procedures / Professional Services, in the Medicare Demonstration Projects subgroup.
Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as T3, N0, M0 (prior to neo-adjuvant therapy, if any) 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 G9091 by major payers:
$53.56
BCBS / Anthem
$9.62
UnitedHealthcare
$0.25
Aetna
$7.71
Cigna
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HCPCS G9091
5 of 25 sample ratesHigher to lower in this preview
Kamran Rajaee
$22.78Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$16.85Published rateEmory Healthcare
Emory University
$13.73Published rateGrady Memorial Hospital Corporation, Grady Health Systems
Grady Memorial Hospital Corporation
$9.96Published rateChristopher Raio
Mercy Medical Center
$6.30Published rate
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See a sample payer proposalHCPCS G9091 vs. Other Medicare Demonstration Projects Codes
The table lists codes related to G9091. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9090-HCPCS | Low | Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as T1-2, N0, M0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a Medicare-approved demonstration project) |
| G9091-HCPCS | Low | Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as T3, N0, M0 (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a Medicare-approved demonstration project) |
| G9092-HCPCS | Low | Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease initially established as T1-3, N1-2, M0 (prior to neo-adjuvant therapy, if any) 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 G9091. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9091 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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