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See a sample rate comparisonHCPCS G9096 Fee Schedule
HCPCS G9096 is classified under Procedures / Professional Services, in the Medicare Demonstration Projects subgroup.
Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; extent of disease initially established as T1-T3, N0-N1 or NX (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 G9096 by major payers:
$58.99
BCBS / Anthem
$9.62
UnitedHealthcare
$0.39
Aetna
$5.41
Cigna
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HCPCS G9096
5 of 25 sample ratesHigher to lower in this preview
David Epstein
Brevard Physician Associates, PLLC
$20.61Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$15.28Published rateCarolina Radiology Associates LLC
Carolina Radiology Associates, LLC
$9.96Published rateEmory Healthcare
Cardiac Arrhythmia Institute
$8.48Published rateAlicia Encinas
Miguel A Arenas Md PC
$6.15Published rate
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See a sample payer proposalHCPCS G9096 vs. Other Medicare Demonstration Projects Codes
The table lists codes related to G9096. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9095-HCPCS | Low | Oncology; disease status; rectal cancer, limited to invasive cancer, adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a Medicare-approved demonstration project) |
| G9096-HCPCS | Low | Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; extent of disease initially established as T1-T3, N0-N1 or NX (prior to neo-adjuvant therapy, if any) with no evidence of disease progression, recurrence, or metastases (for use in a Medicare-approved demonstration project) |
| G9097-HCPCS | Low | Oncology; disease status; esophageal cancer, limited to adenocarcinoma or squamous cell carcinoma as predominant cell type; extent of disease initially established as T4, any N, 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 G9096. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9096 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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