HCPCS C9795
Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions
Retired codeIntensity Modulated Radiation Therapy24 hospitals with prices
This code is retired. Some hospitals still list it. CMS replaced it with HCPCS G0563.
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $7,026 – $10,262 | — | — |
| Deaconess Medical Center | $6,818 – $16,727 | — | — |
| Kadlec Regional Medical Center | $10,682 – $13,482 | — | — |
| Legacy Salmon Creek Medical Center | $10,571 – $15,495 | — | — |
| Mary Bridge Children's Hospital | $7,026 – $29,498 | — | — |
| MultiCare Auburn Medical Center | $7,026 – $17,365 | — | — |
| MultiCare Covington Medical Center | $7,026 – $17,365 | — | — |
| MultiCare Good Samaritan Hospital | $7,026 – $17,365 | — | — |
| MultiCare Valley Hospital | $6,629 – $16,690 | — | — |
| Overlake Hospital Medical Center & Clinics | $8,895 – $13,851 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $7,907 – $13,482 | — | — |
| Providence Centralia Hospital | $13,705 – $28,862 | — | — |
| Providence Holy Family Hospital | $8,735 – $14,737 | — | — |
| Providence Regional Medical Center Everett | $8,273 – $14,299 | — | — |
| Providence St Mary Medical Center | $3,488 – $21,777 | — | — |
| Providence St Peter Hospital | $8,750 – $14,299 | — | — |
| Swedish Edmonds Hospital | $9,847 – $12,256 | — | — |
| Swedish Issaquah | $8,704 – $12,256 | — | — |
| Swedish Medical Center | $10,485 – $14,064 | — | — |
| Swedish Medical Center / Cherry Hill | $10,485 – $14,064 | — | — |
| Tacoma General Allenmore Hospital | $7,026 – $17,365 | — | — |
| University of Washington Medical Ctr | $12,069 – $12,704 | — | — |
| Virginia Mason Medical Center | $10,144 – $13,392 | — | — |
| Yakima Valley Memorial | $10,426 – $12,255 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.