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See a sample rate comparisonHCPCS M1052 Fee Schedule
HCPCS M1052 is classified under Screening Procedures, in the Limb Pain Assessment subgroup.
Leg pain was not measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively
| Key Fact | Detail |
|---|---|
| Service Type | Screening Procedures Limb Pain Assessment |
| Complexity Level | Low |
National average reimbursement for HCPCS M1052 by major payers:
$70.12
BCBS / Anthem
$N/A
UnitedHealthcare
$49.42
Aetna
$N/A
Cigna
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HCPCS M1052
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Payer Contract Negotiation
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See a sample payer proposalHCPCS M1052 vs. Other Limb Pain Assessment Codes
The table lists codes related to M1052. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| M1051-HCPCS | Low | Patient had cancer, acute fracture or infection related to the lumbar spine or patient had neuromuscular, idiopathic or congenital lumbar scoliosis |
| M1052-HCPCS | Low | Leg pain was not measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively |
| M1054-HCPCS | Low | Patient had only urgent care visits during the performance period |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS M1052. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the M1052 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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