CPT 47125 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 Digestive System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • 82 - Assistant surgeon - no qualified resident • 22 - Increased Procedural Services |
| Complexity Level | High |
| CMS | $2,987.52 Physician Fee Schedule |
National average reimbursement for CPT 47125 by major payers:

$3,689.24

$4,104.86

$4,450.78

$4,971.67
| 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 47125 | ||||||
United | 47125 | $2732.00 | 1477140796 - PORTSMOUTH SURGICENTER, LLC | 833659705 - (NH) PORTSMOUTH SURGICENTER LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $303.00 | 1265964050 - SCHAUMBURG SURGERY CENTER, LLC | 813061805 - (IL) SCHAUMBURG SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $100.00 | 1164601696 - SALVATORE DIMERCURIO MD PA | 521833726 - (MD) SALVATORE DIMERCURIO, M.D., P.A. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $1049.00 | 1902302961 - HILL COUNTRY SURGERY CENTER, LLC, SURGERY CENTER OF BOERNE | 352599588 - (TX) HILL COUNTRY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $500.00 | 1265859573 - MODESTO SPECIALTY SURGERY CENTER, PC | 454954897 - (CA) MODESTO SPECIALTY SURGERY CENTER PC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $445.00 | 1912476367 - DIGESTIVE HEALTH SPECIALISTS, PA | 561242980 - (NC) DIGESTIVE HEALTH SPECIALISTS, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $150.00 | 1740264811 - EYES OF YORK SURGICAL CENTER LLC | 200930310 - (PA) EYES OF YORK SURGICAL CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $475.00 | 1104880723 - WNC EYE SURGERY CENTERS INC | 200067898 - (NC) WNC EYE SURGERY CENTERS INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $424.00 | 1942553300 - COLUMBIA SURGICAL INSTITUTE, LLC | 454449408 - (MD) COLUMBIA SURGICAL INSTITUTE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $189.00 | 1841256302 - NEW ENGLAND PAIN CARE | 760718172 | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $9210.00 | 1609876556 - PEAK ONE SURGERY CENTER, LLC, PEAK ONE SURGERY CENTER | 201620230 - (CO) PEAK ONE SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $624.00 | 1467629147 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $1504.00 | 1972874907 - CAPITAL CITY SURGERY CENTER, LLC | 260804803 - (NC) CAPITAL CITY SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $1420.00 | 1649287269 - BAPTIST PLAZA SURGICARE LP, SAINT THOMAS SURGERY CENTER - MIDTOWN | 800033564 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47125 | $610.00 | 1821560434 - SUNSET PAIN SURGERY CENTER | 832872516 - (NV) SUNSET PAIN SURGERY CENTER | NV | 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 47125 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47125 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 47125 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 47125. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47125 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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