What is the standard insurance baseline for HCPCS 0764T?

The standard insurance baseline reimbursement rate is $4.33. This represents the customary allowable amount established across standard fee schedules.

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HCPCS 0764TMedical Service

Assistive Algorithmic Ekg Risk-based Assessment for Heart Dysfunction Based on Ekg Performed at Same Time

Q: What do doctors typically charge for Assistive Algorithmic Ekg Risk-based Assessment for Heart Dysfunction Based on Ekg Performed at Same Time?

The nationwide median physician charge for Assistive Algorithmic Ekg Risk-based Assessment for Heart Dysfunction Based on Ekg Performed at Same Time (HCPCS 0764T) is $99.00. Doctor billed charges vary based on geographic region, setting, and overhead.

Assistive algorithmic ekg risk-based assessment for heart dysfunction based on ekg performed at same time. Clinical pricing breakdown and utilization metrics across 7 practicing doctors nationwide.

$99.00

Peer Median Charge

Gross billed rate

$4.33

Standard Baseline

Customary allowable

22.9x

National Markup

Charge vs baseline

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $99.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $4.33 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 0764T if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"