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See a sample rate comparisonHCPCS G9104 Fee Schedule
HCPCS G9104 is classified under Procedures / Professional Services, in the Medicare Demonstration Projects subgroup.
Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (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 G9104 by major payers:
$58.99
BCBS / Anthem
$9.62
UnitedHealthcare
$0.01
Aetna
$8.55
Cigna
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HCPCS G9104
5 of 25 sample ratesHigher to lower in this preview
Grady Memorial Hospital Corporation, Grady Health Systems
Emory University
$17.28Published rateDavid Epstein
Radiology Associates Of Clearwater, P.A.
$15.07Published rateJulie Webster
Musc Community Physicians
$10.52Published rateJulie Webster
Musc Community Physicians
$8.43Published rateAlicia Encinas
Miguel A Arenas Md PC
$6.15Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9104 vs. Other Medicare Demonstration Projects Codes
The table lists codes related to G9104. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9103-HCPCS | Low | Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; clinical or pathologic M1 at diagnosis, metastatic, locally recurrent, or progressive (for use in a Medicare-approved demonstration project) |
| G9104-HCPCS | Low | Oncology; disease status; gastric cancer, limited to adenocarcinoma as predominant cell type; extent of disease unknown, staging in progress, or not listed (for use in a Medicare-approved demonstration project) |
| G9105-HCPCS | Low | Oncology; disease status; pancreatic cancer, limited to adenocarcinoma as predominant cell type; post R0 resection without 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 G9104. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9104 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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