Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS G9254 Fee Schedule
HCPCS G9254 is classified under Procedures / Professional Services, in the Additional Assorted Quality Measures subgroup.
Documentation of patient discharged to home later than post-operative day 2 following cea or cas
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Assorted Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G9254 by major payers:
$69.94
BCBS / Anthem
$54.00
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G9254.
HCPCS G9254
No sample rates available for this payer and code. Search provider rates to explore coverage.
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS G9254 vs. Other Additional Assorted Quality Measures Codes
The table lists codes related to G9254. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9247-HCPCS | Low | Patient had two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart |
| G9254-HCPCS | Low | Documentation of patient discharged to home later than post-operative day 2 following cea or cas |
| G9255-HCPCS | Low | Documentation of patient discharged to home no later than post operative day 2 following cea or cas |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9254. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9254 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS G9254) and we'll show you how you compare in 15 minutes or less.