CPT 47001 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 Digestive System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • GC - Service performed by resident under supervision |
| Complexity Level | Low |
| CMS | $100.60 Physician Fee Schedule |
National average reimbursement for CPT 47001 by major payers:
$140.90
$141.12
$150.12
$169.44
| 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 47001 | ||||||
United | 47001 | $106.00 | 1306199757 - SONTERRA PROCEDURE CENTER, LLC | 455125802 - (TX) SONTERRA PROCEDURE CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $416.00 | 1336252402 - ADVANCED ENDOSCOPY CENTER LLC | 10719837 - (NY) ADVANCED ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $150.00 | 1306963020 - BATTLE CREEK ENDOSCOPY & SURGERY LLC | 201914507 - (MI) BATTLE CREEK ENDOSCOPY & SURGERY CENTER PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $906.00 | 1851029060 - COLORADO SPRINGS SURGICENTER, LLC | 862813124 - COLORADO SPRINGS SURGICENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $198.00 | 1336687326 - ARROWHEAD SURGERY CENTER LLC | 475111160 - (AZ) ARROWHEAD SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $1831.00 | 1336391085 - MEMORIAL HERMANN SURGERY CENTER KINGSLAND LLC, MEMORIAL HERMANN SURGERY CENTER KINGSLAND | 263464776 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $72.00 | 1538154604 - PAIN MANAGEMENT & SURGERY CENTER OF SOUTHERN INDIANA | 351972676 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $414.00 | 1497090740 - OLOL PONTCHARTRAIN SURGERY CENTER, LLC, OUR LADY OF THE LAKE PONTCHARTRAIN SURGERY CENTER | 461379031 - (LA) OLOL PONTCHARTRAIN SURGERY CENTE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $395.00 | 1174010011 - DTC SURGERY CENTER, LLC, OCC SURGERY CENTER AT INVERNESS | 825181311 - (CO) DTC SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $118.00 | 1649515933 - NAPERVILLE FERTILITY CENTER, INC. | 204056909 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $482.00 | 1902863723 - OAK & MAIN SURGICENTER LLC | 223532371 - (NJ) OAK MAIN SURGICENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $1831.00 | 1003127606 - MEMORIAL HERMANN ENDOSCOPY CENTER NORTH FREEWAY LLC, MEMORIAL HERMANN ENDOSCOPY CENTER NORTH LOOP | 272800702 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $153.00 | 1710952841 - ANDOCHICK SURGICAL CENTER LLC, PHYSICIANS SURGERY CENTER OF FREDERICK | 522239166 - (MD) ANDOCHICK SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $500.00 | 1043835713 - IDAHO ENDOSCOPY CENTER LLC, NAMPA IDAHO ENDOSCOPY CENTER | 270996353 - (ID) IDAHO ENDOSCOPY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47001 | $111.00 | 1730113325 - DHA ENDOSCOPY LLC | 43551976 | MA | 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 47001 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47001 code is part of the Surgery services used for Surgical Procedures on the Digestive System. 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 47001 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 |
|---|---|---|
| 47000-CPT | Moderate | Needle Biopsy Of Liver, Accessed Through The Skin |
| 47001-CPT | Low | Biopsy Of Liver, Needle; When Done For Indicated Purpose At Time Of Other Major Procedure (List Separately In Addition To Code For Primary Procedure) |
| 47010-CPT | High | Hepatotomy Drain Abscess/Cyst,1or 2 Sta |
| 47015-CPT | High | Laparotomy, With Aspiration And/Or Injection Of Hepatic Parasitic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47001. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47001 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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