CPT 0165T Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Category III Codes • Various Services - Category III Codes |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 0165T |
National average reimbursement for CPT 0165T by major payers:
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| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 0165T | ||||||
United | 0165T | $1798.00 | 1285798918 - UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS, UT SOUTHWESTERN UNIVERSITY HOSPITAL | 753175630 | TX | General Acute Care Hospital (282N00000X) |
United | 0165T | $1261.00 | 1215190202 - HARRIS COUNTY HOSPITAL DISTRICT BEN TAUB | 741536936 | TX | General Acute Care Hospital (282N00000X) |
United | 0165T | $606.00 | 1215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 0165T | $2055.00 | 1861994808 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE NORTHEAST CAMPUS | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 0165T | $142.00 | 1679578439 - MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER, CHRISTUS MOTHER FRANCES HOSPITAL TYLER | 750818167 - (TX) MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 0165T | $1514.00 | 1831970532 - VHS SAN ANTONIO PARTNERS, LLC | 760714523 | TX | General Acute Care Hospital (282N00000X) |
United | 0165T | $1400.00 | 1770788168 - TEXAS INSTITUTE FOR SURGERY, LLP, TEXAS INSTITUTE FOR SURGERY AT TEXAS HEALTH PRESBYTERIAN DALLAS | 770628004 - (TX) TEXAS INSTITUTE FOR SURGERY, LLP | TX | General Acute Care Hospital (282N00000X) |
United | 0165T | $361.48 | 1174526529 - TITUS COUNTY HOSPITAL DISTRICT, TITUS REGIONAL MEDICAL CENTER | 756003935 | TX | General Acute Care Hospital (282N00000X) |
United | 0165T | $4837.00 | 1548387418 - THE METHODIST HOSPITAL, HOUSTON METHODIST HOSPITAL | 741180155 - (TX) THE METHODIST HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 0165T | $2242.00 | 1972709970 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE EAST CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 0165T | $1400.00 | 1104976703 - TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN | 752771437 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN | TX | General Acute Care Hospital (282N00000X) |
United | 0165T | $748.00 | 1164750840 - CENTRAL LOUISIANA SURGICAL HOSPITAL LLC, CHRISTUS CENTRAL LOUISIANA SURGICAL HOSPITAL | 264732898 - (LA) CENTRAL LOUISIANA SURGICAL HOSPITAL, LLC | LA | General Acute Care Hospital (282N00000X) |
United | 0165T | $379.00 | 1639377294 - BUNKIE GENERAL HOSPITAL | 720697593 | LA | Critical Access Hospital (282NC0060X) |
United | 0165T | $1484.00 | 1801299375 - OCHSNER MEDICAL CENTER, OCHSNER MEDICAL COMPLEX - RIVER PARISHES | 205432782 | LA | Critical Access Hospital (282NC0060X) |
United | 0165T | $1472.00 | 1497726343 - HILL COUNTRY MEMORIAL HOSPITAL | 742730328 | TX | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 0165T vs. Other Various Services - Category III Codes Codes
The CPT 0165T code is part of the Category III Codes services used for Various Services - Category III Codes. 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 CPT 0165T 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 |
|---|---|---|
| 0165T-CPT | Moderate | Revision Including Replacement Of Total Disc Arthroplasty (Artificial Disc) Anterior Approach Each Additional Interspace Lumbar (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 0165T. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0165T 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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