CPT 47490 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 • GC - Service performed by resident under supervision • AG - Primary physician |
| Complexity Level | Moderate |
| CMS | $319.26 Physician Fee Schedule |
National average reimbursement for CPT 47490 by major payers:
$482.08
$509.86
$521.91
$599.22
| 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 47490 | ||||||
United | 47490 | $1255.00 | 1184976797 - DIGESTIVE HEALTH SPECIALISTS, PA | 561242980 - (NC) DIGESTIVE HEALTH SPECIALISTS, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47490 | $626.00 | 1649662206 - ADVANCED SURGERY CENTER OF ARIZONA, LLP, ADVANCED SURGERY CENTER OF ARIZONA | 471883984 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47490 | $274.00 | 1417606468 - SUMMER EL-KHODARY | 350593390 - DEACONESS HOSPITAL INC | IN | Physician Assistant (363A00000X) |
United | 47490 | $6048.00 | 1215930078 - MARIN HEALTH VENTURES, LLC, MARIN SPECIALTY SURGERY CENTER | 943377073 - (CA) MARIN HEALTH VENTURES, INC. DBA MARIN SPECIALTY SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47490 | $4126.00 | 1093245458 - GREAT LAKES SURGICAL SUITES, LLC, GREAT LAKES SURGICAL SUITES | 821350843 - (IN) GREAT LAKES SURGICAL SUITES, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47490 | $1300.00 | 1508419474 - NORMAN REGIONAL HOSPITAL AUTHORITY, WEST NORMAN ENDOSCOPY | 736048282 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47490 | $1260.00 | 1093993727 - CAROLINA MOUNTAIN GASTROENTEROLOGY ENDOSCOPY CENTER | 261708694 - (NC) CAROLINA MOUNTAIN GASTROENTEROLOGY ENDOSCOPY CENTER | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47490 | $1945.00 | 1396123865 - SOUND SURGEONS PLLC, NORTHWEST WEIGHT LOSS SURGERY | 461190829 - (WA) SOUND SURGEONS, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47490 | $3623.00 | 1730175159 - CHARLOTTE ENDOSCOPIC SURGERY CENTER LLC, CHARLOTTE SURGERY CENTER | 651071112 - (FL) CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47490 | $1176.00 | 1740448711 - TREVOSE SPECIALTY CARE SURGICAL CENTER, LLC | 262420083 - (PA) TREVOSE SPECIALTY CARE SURGICAL CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47490 | $668.00 | 1184666364 - LONG ISLAND CENTER FOR DIGESTIVE HEALTH LLC | 364444162 - (NY) LONG ISLAND CENTER FOR DIGESTIVE HEALTH, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47490 | $858.00 | 1548679046 - GLSD MEDICAL LLC | 471373117 - (WI) GLSD MEDICAL LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47490 | $2406.00 | 1639456973 - PHYSICIAN SURGERY CENTER OF ALBUQUERQUE LLC, POSC OF ABQ LLC | 273193930 - (NM) PHYSICIAN SURGERY CENTER OF ALBUQUERQUE LLC | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47490 | $1964.00 | 1699246181 - DEERBROOK ASC LLC | 823478937 - (TX) DEERBROOK ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47490 | $1100.00 | 1972549491 - UNION CITY ASC LLC, SUMMIT ENDOSCOPY CENTER | 621625423 | TN | 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 47490 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47490 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 47490 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 |
|---|---|---|
| 47460-CPT | High | Transduodenal Sphincterotomy Or Sphincteroplasty, With Or Without Transduodenal Extraction Of Calculus (Separate Procedure) |
| 47480-CPT | High | Cholecystotomy Or Cholecystostomy, Open, W Exploration, Drainage, Or Removal Of Calculus (Separate Procedure) (Revision 2011) |
| 47490-CPT | Moderate | Cholecystostomy, Percutaneous, Complete Procedure, Including Imaging Guidance, Catheter Placement, Cholecystogram When Performed, And Radiological Supervision And Interpretation |
| 47562-CPT | Moderate | Laparoscopy; Cholecystectomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47490. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47490 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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