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Revenue Code (RC) 0403 Fee Schedule

Last Verified: January 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.

Screening mammography

Key FactDetail
Service Type

Other Imaging Services

Complexity LevelModerate

National average reimbursement for Revenue Code 0403 by major payers:

bcbs

$689.59

uhc

$218.87

aetna

$215.86

cigna

$1,425.46

Preview provider-level rates for...
For billing codeRC 0403
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for RC 0403

United
0403$427.001801826912 - WELLMONT HEALTH SYSTEM, LONESOME PINE HOSPITAL621636465 - WELLMONT HEALTH SYSTEMVAGeneral Acute Care Hospital (282N00000X)
United
0403$244.001265740195 - AURORA MEDICAL CENTER GRAFTON, LLC272953799 - AURORA HEALTH CARE INCWIGeneral Acute Care Hospital (282N00000X)
United
0403$208.001629057229 - AHS HILLCREST MEDICAL CENTER, LLC, HILLCREST MEDICAL CENTER770633896 - (OK) AHS HILLCREST MEDICAL CENTER LLCOKGeneral Acute Care Hospital (282N00000X)
United
0403$193.001093705428 - JACKSON MADISON COUNTY GENERAL HOSPITAL626010402 - (TN) JACKSON MADISON COUNTY GENERAL HOSPITALTNGeneral Acute Care Hospital (282N00000X)
United
0403$196.001962024026 - CLHG-RUSTON LLC844422249LAGeneral Acute Care Hospital (282N00000X)
United
0403$336.001205488996 - MOUNTAIN STATES HEALTH ALLIANCE, LEE COUNTY COMMUNITY HOSPITAL620476282 - MOUNTAIN STATES HEALTH ALLIANCEVACritical Access Hospital (282NC0060X)
United
0403$286.001811927544 - MAURY REGIONAL HOSPITAL, WAYNE MEDICAL CENTER621605071 - (TN) MAURY REGIONAL HOSPITALTNGeneral Acute Care Hospital (282N00000X)
United
0403$136.001992755292 - GENEVA COUNTY HEALTHCARE AUTHORITY, INC., WIREGRASS MEDICAL CENTER636004474 - (AL) GENEVA COUNTY HEALTH CARE AUTHORITY INC DBA WIREGRASS MEDICAL CENTERALGeneral Acute Care Hospital (282N00000X)
United
0403$244.001265740195 - AURORA MEDICAL CENTER GRAFTON, LLC272953799 - AURORA HEALTH CARE INCWIGeneral Acute Care Hospital (282N00000X)
United
0403$427.001801826912 - WELLMONT HEALTH SYSTEM, LONESOME PINE HOSPITAL621636465 - WELLMONT HEALTH SYSTEMVAGeneral Acute Care Hospital (282N00000X)
United
0403$446.001801826912 - WELLMONT HEALTH SYSTEM, LONESOME PINE HOSPITAL621636465 - WELLMONT HEALTH SYSTEMVAGeneral Acute Care Hospital (282N00000X)
United
0403$244.001861447179 - AURORA HEALTH CARE METRO, INC.390806181 - AURORA HEALTH CARE INCWIGeneral Acute Care Hospital (282N00000X)
United
0403$177.001023074028 - GEORGE COUNTY HOSPITAL646001398MSRural Acute Care Hospital (282NR1301X)
United
0403$50.001891801718 - HILL HOSPITAL OF YORK, HILL HOSPITAL OF SUMTER COUNTY630961535 - (AL) HILL HOSPITAL OF YORKALGeneral Acute Care Hospital (282N00000X)
United
0403$75.001225068935 - HALE COUNTY HOSPITAL630475297 - (AL) HALE COUNTY HOSPITALALGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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Revenue Code 0403 vs. Other Other Imaging Services Codes

The Revenue Code 0403 code is part of the Other Imaging Services services . 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 Revenue Code 0403 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
0402-RCModerateUltrasound
0403-RCModerateScreening mammography
0404-RCModeratePositron Emission Tomography

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including Revenue Code 0403. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 0403 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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