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See a sample rate comparisonCPT 47100 Fee Schedule
Last Verified: October 2026
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.
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| 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 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 47100 |
| Medicaid Fee Schedule | View Medicaid rates for 47100 |
National average reimbursement for CPT 47100 by major payers:
$1,045.49
$1,114.79
$1,197.30
$1,346.05
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CPT 47100
5 of 25 sample ratesHigher to lower in this preview
Milwaukee Surgical Suites, LLC
$3,400.00Published rateAdvanced Surgery Center Of Bethesda, LLC
Asc Bethesda
$2,388.00Published rateSf Nassau Asc LLC
$1,821.00Published rateBayonet Point Surgery Center Ltd
$1,062.00Published ratePodiatry Group Of Annapolis Ambulatory Surgical Center, Podiatry Group Of Annapolis Ambulatory Surgical Center LLC
Podiatry Group Of Annapolis Ambulatory Surgical Center
$554.00Published rate
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See a sample payer proposalCPT 47100 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47100 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 47100 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47100 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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