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See a sample rate comparisonHCPCS G9364 Fee Schedule
HCPCS G9364 is classified under Procedures / Professional Services, in the Additional Assorted Quality Measures subgroup.
Sinusitis caused by, or presumed to be caused by, bacterial infection
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Assorted Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G9364 by major payers:
$71.06
BCBS / Anthem
$51.00
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G9364
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See a sample payer proposalHCPCS G9364 vs. Other Additional Assorted Quality Measures Codes
The table lists codes related to G9364. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9361-HCPCS | Low | Medical indication for delivery by cesarean birth or induction of labor (<39 weeks of gestation) [documentation of reason(s) for elective delivery (e.g., hemorrhage and placental complications, hypertension, preeclampsia and eclampsia, rupture of membranes (premature or prolonged), maternal conditions complicating pregnancy/delivery, fetal conditions complicating pregnancy/delivery, late pregnancy, prior uterine surgery, or participation in clinical trial)] |
| G9364-HCPCS | Low | Sinusitis caused by, or presumed to be caused by, bacterial infection |
| G9367-HCPCS | Low | At least two orders for high-risk medications from the same drug class |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9364. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9364 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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