CPT 39503 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 • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 82 - Assistant surgeon - no qualified resident • 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 39503 |
National average reimbursement for CPT 39503 by major payers:
$6,944.41
$7,728.23
$7,660.00
$9,366.87
| 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 39503 | ||||||
United | 39503 | $524.00 | 1801890173 - NOVAMED SURGERY CENTER OF CHATTANOOGA LLC | 270039586 - (TN) NOVAMED SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $550.00 | 1225023021 - ARC OF GEORGIA, LLC, PREMIER SURGERY CENTER | 621746313 - (GA) ARC OF GEORGIA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $234.00 | 1245297829 - THE SURGERY CENTER, LLC, THE SURGICAL PAVILION, LLC | 710802581 - (AR) THE SURGICAL PAVILION, LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $1954.00 | 1760035158 - LEIGH ORTHOPEDIC SURGERY CENTER, LLC | 832402528 - (VA) LEIGH ORTHOPEDIC SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $384.00 | 1285678979 - BAY SURGERY CENTERS LLC, CLEARWAY SURGERY CENTER OF ANNAPOLIS | 204934078 - (MD) BAY SURGERY CENTERS LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $565.00 | 1689195786 - SOUTHEAST ATLANTA VASCULAR CARE, LLC | 820825656 - (GA) SOUTHEAST ATLANTA VASCULAR CARE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $485.00 | 1306201124 - CHRISTUS SANTA ROSA OUTPATIENT SURGERY, CHRISTUS PHYSICIANS SURGERY CENTER - SAN MARCOS | 810571409 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $503.00 | 1326508045 - EYE SURGERY CENTER OF LENOIR CITY, LLC | 815283231 - (TN) EYE SURGERY CENTER OF LENOIR CITY LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $200.00 | 1245759356 - DALLAS ASC, LLC, NORTH PARK HEART & VASCULAR SURGERY CENTER | 823468320 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $175.00 | 1083382154 - TRI-CITY SURGICAL CENTERS, LLC | 825357044 - (AZ) TRICITY SURGICAL CENTERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $1028.00 | 1831489335 - HAGERSTOWN SURGERY CENTER,LLC | 274935096 - (MD) HAGERSTOWN SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $1000.00 | 1689814998 - PUGET SOUND SURGICAL CLINIC INC | 911687859 - (WA) PUGET SOUND SURGICAL CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $2172.00 | 1609870336 - DESOTO SURGICARE PARTNERS, LTD, NORTH TEXAS SURGERY CENTER | 752592508 - (TX) DESOTO SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $520.00 | 1316190077 - CERRITOS SURGERY CENTER, LLC, CERRITOS SURGERY CENTER, LLC | 651211028 - (CA) CERRITOS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39503 | $1064.00 | 1326142878 - LEBANON ENDOSCOPY CENTER LLC, LEBANON ENDOSCOPY CENTER | 205449574 - (TN) LEBANON ENDOSCOPY CENTER LLC | TN | 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 39503 vs. Other Surgical Procedures on the Mediastinum and Diaphragm Codes
The CPT 39503 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 39503 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 |
|---|---|---|
| 39503-CPT | High | Repair, Neonatal Diaphragmatic Hernia, With Or Without Chest Tube Insertion And With Or Without Creation Of Ventral Hernia |
| 39540-CPT | High | Rep.Diaphragmat.Hernia,Traum;Acute |
| 39541-CPT | High | Repair, Diaphragmatic Hernia,Traumatic;C |
| 39545-CPT | High | Imbricatn-Diaphr-Eventratn;Paralytc |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 39503. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 39503 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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