FDFairDoctor.org
Home/Procedures/Two Standard Insurance Diabetes Prevention Program Mdpp Core Maintenance Sessions Ms Were Attended by an Mdpp Beneficiary in Months Mo 7-9 Under the Mdpp Expanded Model Em a Core Maintenance Session Is an Mdpp Service That 1 Is Furnished by an Mdpp Suppl
HCPCS G9876Medical Service

Two Standard Insurance Diabetes Prevention Program Mdpp Core Maintenance Sessions Ms Were Attended by an Mdpp Beneficiary in Months Mo 7-9 Under the Mdpp Expanded Model Em a Core Maintenance Session Is an Mdpp Service That 1 Is Furnished by an Mdpp Suppl

Two standard insurance diabetes prevention program (mdpp) core maintenance sessions (ms) were attended by an mdpp beneficiary in months (mo) 7-9 under the mdpp expanded model (em). a core maintenance session is an mdpp service that: (1) is furnished by an mdpp suppl. Clinical pricing breakdown and utilization metrics across 3 practicing doctors nationwide.

$76.00
Peer Median Charge
Gross billed rate
$74.48
Standard Baseline
Customary allowable
1.0x
National Markup
Charge vs baseline
3
Active Physicians
Billing this code
Planning care or already received a bill for CPT G9876?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $76.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $74.48 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 G9876 if paid upfront?"
  • "Are there separate facility, anesthesia, or pathology fees associated with this procedure?"