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See a sample rate comparisonHCPCS G9116 Fee Schedule
HCPCS G9116 is classified under Procedures / Professional Services, in the Medicare Demonstration Projects subgroup.
Oncology; disease status; ovarian cancer, limited to epithelial cancer; evidence of disease progression, or recurrence, and/or platinum resistance (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 G9116 by major payers:
$58.99
BCBS / Anthem
$9.62
UnitedHealthcare
$0.23
Aetna
$4.57
Cigna
Compare published rates across providers.
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HCPCS G9116
5 of 25 sample ratesHigher to lower in this preview
Jacob Holloway
$22.78Published rateChu Chen
$16.09Published rateMiguel Arenas
Miguel A Arenas Md PC
$10.18Published 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 G9116 vs. Other Medicare Demonstration Projects Codes
The table lists codes related to G9116. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9115-HCPCS | Low | Oncology; disease status; ovarian cancer, limited to epithelial cancer; pathologic Stage III-IV; without evidence of progression, recurrence, or metastases (for use in a Medicare-approved demonstration project) |
| G9116-HCPCS | Low | Oncology; disease status; ovarian cancer, limited to epithelial cancer; evidence of disease progression, or recurrence, and/or platinum resistance (for use in a Medicare-approved demonstration project) |
| G9117-HCPCS | Low | Oncology; disease status; ovarian cancer, limited to epithelial cancer; 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 G9116. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9116 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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