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See a sample rate comparisonHealthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Services Blood and Blood Products, with Associated Procedures |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for P9026 |
National average reimbursement for HCPCS P9026 by major payers:

$163.71

$N/A

$425.28

$N/A
Choose a payer to see a sample of rates for HCPCS P9026.
Lake Surgical Hospital Slidell, LLC Dba Southern Surgical Hospital
Omega Hospital, LLC
Willis-Knighton Medical Center
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Rate Benchmarking
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See a sample payer proposalHCPCS P9026 vs. Other Blood and Blood Products, with Associated Procedures Codes
The HCPCS P9026 code is part of the Pathology and Laboratory Services services used for Blood and Blood Products, with Associated Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS P9026 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| P9025-HCPCS | Moderate | Plasma, cryoprecipitate reduced, pathogen reduced, each unit |
| P9026-HCPCS | Low | Cryoprecipitated fibrinogen complex, pathogen reduced, each unit |
| P9031-HCPCS | Low | Platelets, leukocytes reduced, each unit |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS P9026. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the P9026 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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