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See a sample rate comparisonHealthcare 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 |
| Medicare Fee Schedule | View Medicare rates for 47539 |
| Medicaid Fee Schedule | View Medicaid rates for 47539 |
National average reimbursement for CPT 47539 by major payers:

$5,036.52

$6,420.00

$6,043.17

$1,141.96
Choose a payer to see a sample of rates for CPT 47539.
Fort Worth Endoscopy Centers LLC
Puget Sound Surgical Center LLC
Texas Eye Surgery Center LLC
North Florida Surgery Center Inc
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 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 | Perq Plmt Bile Duct Stent, Placement Of Stent S Into A Bile Duct Percutaneous Including Diagnostic Cholangiography Imaging Guidance Eg Fluoroscopy And Or Ultrasound Balloon Dilation Catheter Exchange S And Catheter Removal S When Performed And All Associated Radiological Supervision And Interpretation New Access Without Placement Of Separate Biliary Drainage Catheter |
| 47540-CPT | High | Perq Plmt Bile Duct Stent, Placement Of Stent S Into A Bile Duct Percutaneous Including Diagnostic Cholangiography Imaging Guidance Eg Fluoroscopy And Or Ultrasound Balloon Dilation Catheter Exchange S And Catheter Removal S When Performed And All Associated Radiological Supervision And Interpretation New Access With Placement Of Separate Biliary Drainage Catheter Eg External Or Internal External |
| 47541-CPT | High | Plmt Access Bil Tree Sm Bwl, Placement Of Access Through The Biliary Tree And Into Small Bowel To Assist With An Endoscopic Biliary Procedure Eg Rendezvous Procedure Percutaneous Including Diagnostic Cholangiography When 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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