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See a sample rate comparisonHCPCS G9607 Fee Schedule
HCPCS G9607 is classified under Procedures / Professional Services, in the Additional Assorted Quality Measures subgroup.
Documented medical reasons for not performing intraoperative cystoscopy (e.g., urethral pathology precluding cystoscopy, any patient who has a congenital or acquired absence of the urethra) or in the case of patient death
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Additional Assorted Quality Measures |
| Complexity Level | Low |
National average reimbursement for HCPCS G9607 by major payers:
$71.46
BCBS / Anthem
$N/A
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G9607
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G9607 vs. Other Additional Assorted Quality Measures Codes
The table lists codes related to G9607. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9606-HCPCS | Low | Intraoperative cystoscopy performed to evaluate for lower tract injury |
| G9607-HCPCS | Low | Documented medical reasons for not performing intraoperative cystoscopy (e.g., urethral pathology precluding cystoscopy, any patient who has a congenital or acquired absence of the urethra) or in the case of patient death |
| G9608-HCPCS | Low | Intraoperative cystoscopy not performed to evaluate for lower tract injury |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9607. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9607 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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