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See a sample rate comparisonHCPCS G9894 Fee Schedule
HCPCS G9894 is classified under Procedures / Professional Services, in the Radiology services Prostate subgroup.
Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Radiology services Prostate |
| Complexity Level | Low |
National average reimbursement for HCPCS G9894 by major payers:
$71.05
BCBS / Anthem
$N/A
UnitedHealthcare
$0.01
Aetna
$1.16
Cigna
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HCPCS G9894
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See a sample payer proposalHCPCS G9894 vs. Other Radiology services Prostate Codes
The table lists codes related to G9894. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| G9894-HCPCS | Low | Androgen deprivation therapy prescribed/administered in combination with external beam radiotherapy to the prostate |
| G9895-HCPCS | Low | Documentation of medical reason(s) for not prescribing/administering androgen deprivation therapy in combination with external beam radiotherapy to the prostate (e.g., salvage therapy) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G9894. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G9894 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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