CPT 47539 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 |
| Common Modifiers | • None • GC - Service performed by resident under supervision • AG - Primary physician |
| Complexity Level | High |
| CMS | $3,826.27 Physician Fee Schedule |
National average reimbursement for CPT 47539 by major payers:
$5,036.52
$6,420.00
$6,043.17
$7,022.32
| 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 47539 | ||||||
United | 47539 | $2744.00 | 1477594422 - SURGERY CENTER OF AVENTURA LTD | 113765789 - (FL) SURGERY CENTER OF AVENTURA LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $8087.00 | 1184922353 - PEARLAND SURGERY CENTER, LLC | 270289493 - (TX) PEARLAND SURGERY CENTER, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $936.00 | 1760423180 - CENTRAL COAST ENDOSCOPY CENTER INC | 770456846 - (CA) CENTRAL COAST ENDOSCOPY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $1957.00 | 1255347050 - MARYLAND EYE SURGERY CENTER, L.L.C., THE SURGERY CENTER | 522205280 - (MD) MARYLAND EYE SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $3489.00 | 1013309459 - MELBOURNE SURGERY CENTER, LLC, MELBOURNE SURGERY CENTER | 582101921 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $2500.00 | 1982745568 - NORTHWEST SURGERY CENTER, INC | 911405577 - (WA) NORTHWEST SURGERY CENTER INC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $900.00 | 1780923128 - MACOMB ENDOSCOPY CENTER PLC | 275015226 - (MI) MACOMB ENDOSCOPY CENTER PLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $7415.00 | 1891286860 - SANDY SPRINGS CENTER FOR UROLOGIC SURGERY LLC | 825437441 - (GA) SANDY SPRINGS CENTER FOR UROLOGIC SURGERY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $3514.00 | 1164007068 - SW HEALTH LP | 853293126 - (TX) SW HEALTH LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $1400.00 | 1619284536 - CHILDRENS SURGERY CENTER, LLC | 273074039 - (PA) CHILDRENS SURGERY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $5851.00 | 1316109309 - PROLIANCE SURGEONS INC PS, PLASTIC & RECONSTRUCTIVE SURGEONS ASC | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $3275.00 | 1366809055 - DFW CHILDRENS SURGERY CENTER LLC | 475442947 - (TX) DFW CHILDRENS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $2258.00 | 1326132291 - MADISON STREET SURGERY CENTER, LLC | 841499650 - (CO) MADISON STREET SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $2237.00 | 1891754271 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, DIGESTIVE HEALTH NETWORK ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47539 | $4818.00 | 1710231642 - ADVANCED REGIONAL SURGERY CENTER, LLC | 461072979 - (IN) ADVANCED REGIONAL SURGERY CENTER LLC | IN | 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 47539 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47539 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 47539 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 |
|---|---|---|
| 47538-CPT | High | Placement Of Stent(S) Into A Bile Duct Percutaneous Including Diagnostic Cholangiography Imaging Guidance (Eg Fluoroscopyand/Or Ultrasound) Balloon Dilation Catheter Exchange(S) And Catheter Removal(S) When Performed And All Associated Radiological Supervision And Interpretation; Existing Access. (Desc Revised 1/1/2017) |
| 47539-CPT | High | Placement Of Stent(S) Into A Bile Duct Percutaneous Including Diagnostic Cholangiographyimaging Guidance (Eg Fluoroscopy And/Or Ultrasound) Balloon Dilation Catheter Exchange Or Removal When Performed And All Associated Radiological Supervision And Interpretation Each Stent; New Access Without Placement Of Separate Biliary Drainage Catheter. |
| 47540-CPT | High | Placement Of Stent(S) Into A Bile Duct Percutaneous Including Diagnostic Cholangiographyimaging Guidance (Eg Fluoroscopy And/Or Ultrasound) Balloon Dilation Catheter Exchange Or Removal When Performed And All Associated Radiological Supervision And Interpretation Each Stent; New Access With Placement Of Separate Biliary Drainage Catheter (Eg External Or Internal-External). |
| 47541-CPT | High | Placement Of Access Through The Biliary Tree And Into Small Bowel To Assist With An Endoscopic Biliary Procedure (Eg Rendezvous Procedure) Percutaneous Including Diagnostic Cholangiographywhen Performed Imaging Guidance (Eg Ultrasound And/Or Fluoroscopy) And All Associated Radiological Supervision And Interpretation; New Access. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47539. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47539 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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