CPT 39560 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.
| 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 • 51 - Multiple procedures • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 39560 |
National average reimbursement for CPT 39560 by major payers:
$996.73
$1,046.98
$1,094.46
$1,319.01
| 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 39560 | ||||||
United | 39560 | $582.00 | 1205878758 - ALBUQUERQUE AMBULATORY EYE SURGERY CENTER, LLC | 850481490 - (NM) ALBUQUERQUE AMBULATORY EYE SURGERY CENTER LLC | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $226.00 | 1528134293 - MARYLAND AESTHETIC AND RECONSTRUCTIVE AMBULATORY SURGICAL CENTER LLC | 522277480 - (MD) MARYLAND AESTHETIC AND RECONSTRUCTIVE AMBULATORY SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $1028.00 | 1295060069 - TIMONIUM SURGERY CENTER, LLC | 270399689 - (MD) TIMONIUM SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $1064.00 | 1699777540 - PHYSICIANS SURGERY CENTER OF TEMPE, LLC, PHYSICIANS SURGERY CENTER OF TEMPE | 731538769 - (AZ) PHYSICIANS SURGERY CENTER OF TEMPE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $852.00 | 1609872597 - COLISEUM SAME DAY SURGERY CENTER LP | 621805346 - (GA) COLISEUM SAME DAY SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $500.00 | 1790265999 - MUVE | 822351627 - (PA) MUVE | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $450.00 | 1649463605 - PRINCETON ORTHOPAEDIC ASSOCIATES II PA | 223471829 - (NJ) PRINCETON ORTHOPAEDIC ASSOCIATES II, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $786.00 | 1023169380 - JCMG SURGERY CENTER, INC. | 431809950 - (MO) JCMG SURGERY CENTER INC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $1103.00 | 1649317660 - ORTHOVIRGINIA, INC | 540885859 - (VA) ORTHOVIRGINIA, INC. | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $491.00 | 1467010736 - MERCY SURGERY CENTER LLC | 841875159 - (IA) MERCY SURGERY CENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $1231.00 | 1629559208 - ORTHOARIZONA SURGERY CENTER GILBERT, LLC, ORTHOARIZONA SURGERY CENTER GILBERT | 823624585 - (AZ) ORTHOARIZONA SURGERY CENTER GILBERT LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $100.00 | 1487187076 - GREEN VALLEY SURGERY CENTER LLC | 812240255 - (NV) GREEN VALLEY SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $417.00 | 1467582437 - NORTH FLORIDA SURGERY CENTER INC, NORTH FLORIDA SURGERY CENTER | 593377918 - (FL) NORTH FLORIDA SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $822.00 | 1730121401 - SALEM ENDOSCOPY CENTER, LLC | 202447516 - (OR) SALEM ENDOSCOPY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 39560 | $734.00 | 1205881935 - HERITAGE EYE CENTER LC, HERITAGE SURGERY CENTER LC | 752409758 - (TX) HERITAGE EYE CENTER LC | TX | 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 39560 vs. Other Surgical Procedures on the Mediastinum and Diaphragm Codes
The CPT 39560 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 39560 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 |
| 39560-CPT | Moderate | Resection, Diaphragm; With Simple Repair (Eg, Primary Suture) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 39560. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 39560 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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