CPT 47381 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • 51 - Multiple procedures • XS - Separate Structure • AG - Primary physician |
| Complexity Level | High |
| CMS | $1,445.89 Physician Fee Schedule |
National average reimbursement for CPT 47381 by major payers:
$1,827.34
$1,958.22
$2,012.85
$2,388.99
| 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 47381 | ||||||
United | 47381 | $2706.48 | 1124022595 - THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS, LLC, SURGERY CENTER CEDAR RAPIDS | 721550812 - (IA) THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $492.00 | 1861089666 - BARNET DULANEY PERKINS EYE CENTER, PC, BDPEC ASC TUCSON 5TH ST | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $1955.00 | 1780683490 - METROCREST SURGERY CENTER LP, BAYLOR SURGICARE AT CARROLLTON | 30380493 - (TX) METROCREST SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $1146.00 | 1760907919 - BANNER SUN CITY WEST SURGERY CENTER LLC | 901182684 - (AZ) BANNER SUN CITY WEST SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $775.00 | 1679531610 - BOSTON UNIVERSITY EYE ASSOCIATES, INC., BOSTON UNIVERSITY EYE ASSOCIATES SURGERY & LASER CENTER | 43137333 - (MA) BOSTON UNIVERSITY EYE ASSOCIATES INC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $2428.00 | 1023070026 - TOMS RIVER SURGERY CENTER, LLC, TOMS RIVER SURGERY CENTER | 752854783 - (NJ) TOMS RIVER SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $4621.00 | 1346792165 - HSS ASC OF MANHATTAN LLC, HSS ASC OF MANHATTAN | 471353602 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $850.00 | 1477695336 - SOMERSET OUTPATIENT SURGERY, LLC, RARITAN VALLEY SURGERY CENTER | 208433398 - (NJ) SOMERSET OUTPATIENT SURGERY, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $897.00 | 1346621893 - NORTHERN NEW JERSEY CENTER FOR ADVANCED ENDOSCOPY LLC | 472128570 - (NJ) NORTHERN NEW JERSEY CENTER FOR ADVANCED ENDOSCOPY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $550.00 | 1437110293 - ST. VINCENT-ARKANSAS ORTHOPAEDIC SURGERY CENTER LLC | 710813827 - (AR) ST VINCENTARKANSAS ORTHOPAEDIC SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $1064.00 | 1538609011 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY - SOUTHSIDE | 384016302 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $1955.00 | 1336459353 - LONE STAR ENDOSCOPY CENTER LLC | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $911.00 | 1144265539 - THE MIDLAND SURGICAL CENTER LLC | 352194610 - (IL) THE MIDLAND SURGICAL CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $430.00 | 1457640112 - MID-MICHIGAN ENDOSCOPY CENTER, PLLC, CHARTER ENDOSCOPY CENTER | 201979186 - (MI) MID MICHIGAN ENDOSCOPY CENTER | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47381 | $1697.00 | 1033517263 - ISLAND AMBULATORY SURGERY CENTER | 464518870 - (NY) ISLAND AMBULATORY SURGERY CENTER | NY | 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 47381 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47381 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 47381 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 |
|---|---|---|
| 47370-CPT | High | Laparoscopy, Surgical, Ablation Of One Or More Liver Tumor(S); Radiofrequency |
| 47380-CPT | High | Ablation, Open, Of One Or More Liver Tumor(S); Radiofrequency |
| 47381-CPT | High | Ablation, Open, Of One Or More Liver Tumor(S); Cryosurgical |
| 47382-CPT | High | Ablation, One Or More Liver Tumor(S), Percutaneous, Radiofrequency |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47381. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47381 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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