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HCPCS S9976 Fee Schedule

Last Verified: September 2026

Healthcare 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.

Lodging, per diem, not otherwise classified
Key FactDetail
Service Type

Temporary National Codes (Non-Medicare)

Various Services, Fees, and Costs

Common Place of Service

99 - Other POS

None

Complexity LevelLow

National average reimbursement for HCPCS S9976 by major payers:

bcbs

$62.55

uhc

$94.58

aetna

$68.21

cigna

$127.21

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HCPCS S9976

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HCPCS S9976 vs. Other Various Services, Fees, and Costs Codes

The HCPCS S9976 code is part of the Temporary National Codes (Non-Medicare) services used for Various Services, Fees, and Costs. 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 S9976 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.

CodeComplexityDescription
S9975-HCPCSLowTransplant related lodging, meals and transportation, per diem
S9976-HCPCSLowLodging, per diem, not otherwise classified
S9977-HCPCSLowMeals, per diem, not otherwise specified

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S9976. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the S9976 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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