Revenue Code (RC) 0403 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.
Screening mammography
| Key Fact | Detail |
|---|---|
| Service Type | • Other Imaging Services |
| Complexity Level | Moderate |
National average reimbursement for Revenue Code 0403 by major payers:

$689.59

$218.87

$215.86

$1,425.46
| 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 RC 0403 | ||||||
United | 0403 | $398.00 | 1689682999 - BERGEN COUNTY IMPROVEMENT AUTHORITY, BERGEN NEW BRIDGE MEDICAL CENTER | 223240487 | NJ | General Acute Care Hospital (282N00000X) |
United | 0403 | $389.00 | 1477531580 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 0403 | $142.00 | 1629025648 - SAINT THOMAS WEST HOSPITAL, ASCENSION SAINT THOMAS HOSPITAL | 620347580 - (TN) SAINT THOMAS WEST HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 0403 | $476.00 | 1811940976 - MACON NORTHSIDE HOSPITAL, LLC, PIEDMONT MACON NORTH HOSPITAL | 621736985 - (GA) MACON NORTHSIDE HOSPITAL LLC | GA | General Acute Care Hospital (282N00000X) |
United | 0403 | $80.00 | 1588648315 - POINTE COUPEE PARISH HEALTH SERVICES DISTRICT NUMBER ONE, POINTE COUPEE GENERAL HOSPITAL | 721054801 | LA | Critical Access Hospital (282NC0060X) |
United | 0403 | $193.00 | 1518957950 - BOLIVAR GENERAL HOSPITAL, INC., WEST TENNESSEE HEALTHCARE BOLIVAR HOSPITAL | 621624171 - (TN) BOLIVAR GENERAL HOSPITAL INC | TN | Critical Access Hospital (282NC0060X) |
United | 0403 | $286.00 | 1699754812 - HARDIN COUNTY GENERAL HOSPITAL, HARDIN MEDICAL CENTER | 626002428 - (TN) HARDIN COUNTY GENERAL HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 0403 | $175.00 | 1699876094 - INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC, IU HEALTH TIPTON HOSPITAL | 262772226 - (IN) INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC | IN | Critical Access Hospital (282NC0060X) |
United | 0403 | $446.00 | 1124058615 - WELLMONT HEALTH SYSTEM, BRISTOL REGIONAL MEDICAL CENTER | 621636465 - WELLMONT HEALTH SYSTEM | TN | General Acute Care Hospital (282N00000X) |
United | 0403 | $244.00 | 1861447179 - AURORA HEALTH CARE METRO, INC. | 390806181 - AURORA HEALTH CARE INC | WI | General Acute Care Hospital (282N00000X) |
United | 0403 | $196.00 | 1962024026 - CLHG-RUSTON LLC | 844422249 | LA | General Acute Care Hospital (282N00000X) |
United | 0403 | $193.00 | 1093705428 - JACKSON MADISON COUNTY GENERAL HOSPITAL | 626010402 - (TN) JACKSON MADISON COUNTY GENERAL HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 0403 | $189.00 | 1447303227 - GULF HEALTH HOSPITALS, INC, THOMAS HOSPITAL | 630891904 - (AL) GULF HEALTH HOSPITALS INC | AL | General Acute Care Hospital (282N00000X) |
United | 0403 | $198.00 | 1033112230 - ST JUDE CHILDRENS RESEARCH HOSPITAL INC | 620646012 - ST JUDE CHILDRENS RESEARCH HOSPITAL INC | TN | Children's Hospital (282NC2000X) |
United | 0403 | $145.00 | 1164590386 - SAINT THOMAS RUTHERFORD HOSPITAL, ASCENSION SAINT THOMAS RUTHERFORD | 620475842 - SAINT THOMAS RUTHERFORD HOSPITAL | TN | 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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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.
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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