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See a sample rate comparisonHCPCS G9354 Fee Schedule
HCPCS G9354 is classified under Procedures / Professional Services, in the Additional Assorted Quality Measures subgroup.
One CT scan or no CT scan of the paranasal sinuses ordered within 90 days after the date of diagnosis
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Assorted Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G9354 by major payers:
$63.33
BCBS / Anthem
$54.00
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G9354
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See a sample payer proposalHCPCS G9354 vs. Other Additional Assorted Quality Measures Codes
The table lists codes related to G9354. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9353-HCPCS | Low | More than one CT scan of the paranasal sinuses ordered or received within 90 days after the date of diagnosis for documented reasons (e.g., patients with complications, second CT obtained prior to surgery, other medical reasons) |
| G9354-HCPCS | Low | One CT scan or no CT scan of the paranasal sinuses ordered within 90 days after the date of diagnosis |
| G9355-HCPCS | Low | Elective delivery (without medical indication) by cesarean birth or induction of labor not performed (<39 weeks of gestation) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9354. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9354 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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