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Revenue Code (RC) 0403 Fee Schedule

Last Verified: April 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$398.001689682999 - BERGEN COUNTY IMPROVEMENT AUTHORITY, BERGEN NEW BRIDGE MEDICAL CENTER223240487NJGeneral Acute Care Hospital (282N00000X)
United
0403$389.001477531580 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITYCOGeneral Acute Care Hospital (282N00000X)
United
0403$142.001629025648 - SAINT THOMAS WEST HOSPITAL, ASCENSION SAINT THOMAS HOSPITAL620347580 - (TN) SAINT THOMAS WEST HOSPITALTNGeneral Acute Care Hospital (282N00000X)
United
0403$476.001811940976 - MACON NORTHSIDE HOSPITAL, LLC, PIEDMONT MACON NORTH HOSPITAL621736985 - (GA) MACON NORTHSIDE HOSPITAL LLCGAGeneral Acute Care Hospital (282N00000X)
United
0403$80.001588648315 - POINTE COUPEE PARISH HEALTH SERVICES DISTRICT NUMBER ONE, POINTE COUPEE GENERAL HOSPITAL721054801LACritical Access Hospital (282NC0060X)
United
0403$193.001518957950 - BOLIVAR GENERAL HOSPITAL, INC., WEST TENNESSEE HEALTHCARE BOLIVAR HOSPITAL621624171 - (TN) BOLIVAR GENERAL HOSPITAL INCTNCritical Access Hospital (282NC0060X)
United
0403$286.001699754812 - HARDIN COUNTY GENERAL HOSPITAL, HARDIN MEDICAL CENTER626002428 - (TN) HARDIN COUNTY GENERAL HOSPITALTNGeneral Acute Care Hospital (282N00000X)
United
0403$175.001699876094 - INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC, IU HEALTH TIPTON HOSPITAL262772226 - (IN) INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INCINCritical Access Hospital (282NC0060X)
United
0403$446.001124058615 - WELLMONT HEALTH SYSTEM, BRISTOL REGIONAL MEDICAL CENTER621636465 - WELLMONT HEALTH SYSTEMTNGeneral Acute Care Hospital (282N00000X)
United
0403$244.001861447179 - AURORA HEALTH CARE METRO, INC.390806181 - AURORA HEALTH CARE INCWIGeneral Acute Care Hospital (282N00000X)
United
0403$196.001962024026 - CLHG-RUSTON LLC844422249LAGeneral 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$189.001447303227 - GULF HEALTH HOSPITALS, INC, THOMAS HOSPITAL630891904 - (AL) GULF HEALTH HOSPITALS INCALGeneral Acute Care Hospital (282N00000X)
United
0403$198.001033112230 - ST JUDE CHILDRENS RESEARCH HOSPITAL INC620646012 - ST JUDE CHILDRENS RESEARCH HOSPITAL INCTNChildren's Hospital (282NC2000X)
United
0403$145.001164590386 - SAINT THOMAS RUTHERFORD HOSPITAL, ASCENSION SAINT THOMAS RUTHERFORD620475842 - SAINT THOMAS RUTHERFORD HOSPITALTNGeneral 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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