CPT 39010 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Mediastinum and Diaphragm |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 78 - Return to OR - related procedure • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 39010 |
National average reimbursement for CPT 39010 by major payers:
$1,031.87
$1,052.19
$1,069.02
$1,305.87
| 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 39010 | ||||||
United | 39010 | $676.00 | 1427017813 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, PENINSULA ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $517.00 | 1558720235 - DHCH LLC | 811030907 - (NY) DHCH, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $544.00 | 1114923471 - SURGICARE CENTER OF IDAHO, LLC | 820513482 - (ID) SURGICARE CENTER OF IDAHO LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $641.00 | 1295288751 - PLASTIC HEAD AND NECK SURGERY INSTITUTE | 812018399 - (GA) PLASTIC HEAD AND NECK SURGERY INSTITUTE | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $867.00 | 1609825298 - SURGERY CENTER OF IDAHO LLC | 204831740 - (ID) SURGERY CENTER OF IDAHO LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $983.00 | 1891257473 - WESTGATE SURGERY CENTER, LLC, WESTGATE SURGERY CENTER | 352651945 - (AZ) WESTGATE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $461.00 | 1720227176 - ST. AGNES HEALTHCARE, INC., GEORGE THOMAS GRACE M.D. SURGERY CENTER | 520591657 - ST AGNES HEALTHCARE INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $1073.00 | 1740681733 - SURGCENTER OF GREATER PHOENIX, LLC | 465683789 - (AZ) SURGCENTER OF GREATER PHOENIX LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $441.00 | 1528340213 - UNIVERSITY CENTER FOR AMBULATORY SURGERY, LLC | 453017917 - (NJ) UNIVERSITY CENTER FOR AMBULATORY SURGERY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $600.00 | 1003166844 - PSA AMBULATORY SURGERY CENTER OF KILLEEN LLC | 455218356 - (TX) PSA AMBULATORY SURGERY CENTER OF KILLEEN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $427.00 | 1528153111 - MECHANICSVILLE AMBULATORY SURGERY CENTER, LLC | 200767912 - (MD) MECHANICSVILLE AMBULATORY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $2336.00 | 1821141284 - CENTER FOR HEALTH AMBULATORY SURGERY CENTER, LLC | 205557171 - (IL) CENTER FOR HEALTH AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $1049.00 | 1245529189 - CAPITOL SURGICAL CENTER LLC | 275067646 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $4825.00 | 1982680492 - ROCKLAND SURGICAL PROJECT, LLC, RAMAPO VALLEY SURGICAL CENTER | 200580403 - (NJ) ROCKLAND SURGICAL PROJECT LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39010 | $1344.00 | 1922237213 - ENDOSCOPY CENTER OF TOMS RIVER, LLC | 300568338 - (NJ) ENDOSCOPY CENTER OF TOMS RIVER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 39010 vs. Other Surgical Procedures on the Mediastinum and Diaphragm Codes
The CPT 39010 code is part of the Surgery services used for Surgical Procedures on the Mediastinum and Diaphragm. 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 39010 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 |
|---|---|---|
| 38794-CPT | Moderate | Cannulation Thoracic Duct |
| 38900-CPT | Moderate | Intraoperative Identification (Eg, Mapping) Of Sentinel Lymph Node(S) Includes Injection Of Non-Radioactive Dye, When Performed (List Separately In Addition To Code For Primary Procedure) |
| 39000-CPT | Moderate | Mediastinotomy W Exp/Drain Cervical |
| 39010-CPT | High | Mediastinotomy With Exploration, Drainage, Removal Of Foreign Body, Or Biopsy; Transthoracic Approach, Including Either Transthoracic Or Median Sternotomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 39010. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 39010 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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