CPT 47543 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 • 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 47543 |
National average reimbursement for CPT 47543 by major payers:
$776.52
$1,101.43
$802.12
$937.19
| 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 47543 | ||||||
United | 47543 | $826.29 | 1447264759 - DEACONESS HOSPITAL, INC, <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Geriatric Medicine (Internal Medicine) Physician (207RG0300X) |
United | 47543 | $888.11 | 1972761591 - SETH LESSNER | 133843560 - CRYSTAL RUN HEALTHCARE PHYSICIANS, LLP | NY | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | 47543 | $2304.72 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 47543 | $865.84 | 1013151208 - NAVEEN GUMPENI | 462333282 - KINGS PHYSICIAN SERVICES PC | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 47543 | $366.05 | 1053866707 - BRITTANY PTACHICK | 541958039 - HROA 401K PLAN | VA | Family Nurse Practitioner (363LF0000X) |
United | 47543 | $3048.19 | 1730279530 - RANON MANN | 131740114 - MONTEFIORE MEDICAL CENTER | NY | Dermatology Physician (207N00000X) |
United | 47543 | $340.27 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 47543 | $412.04 | 1730279530 - RANON MANN | 131740114 - MONTEFIORE MEDICAL CENTER | NY | Dermatology Physician (207N00000X) |
United | 47543 | $865.84 | 1063585180 - BABRAK CARVAN | 462333282 - KINGS PHYSICIAN SERVICES PC | NY | Pediatrics Physician (208000000X) |
United | 47543 | $1423.05 | 1013995620 - EDUARDO PINTO | 133843560 - CRYSTAL RUN HEALTHCARE PHYSICIANS, LLP | NY | Hospitalist Physician (208M00000X) |
United | 47543 | $2952.46 | 1811000177 - CHARLESTON RADIOLOGISTS PA | 570634747 - CHARLESTON RADIOLOGISTS, P.A. | SC | Single Specialty Group (193400000X) |
United | 47543 | $177.82 | 1013534106 - NATALIA CASTRO | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Family Nurse Practitioner (363LF0000X) |
United | 47543 | $915.21 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 47543 | $379.64 | 1336541275 - WILLIAM SALINAS | 350593390 - DEACONESS HOSPITAL INC | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | 47543 | $1280.75 | 1013995620 - EDUARDO PINTO | 133843560 - CRYSTAL RUN HEALTHCARE PHYSICIANS, LLP | NY | Hospitalist Physician (208M00000X) |
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 47543 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47543 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 47543 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). |
| 47543-CPT | Moderate | Endoluminal Biopsy(Ies) Of Biliary Tree Percutaneous Any Method(S) (Eg Brush Forceps And/Or Needle) Including Imaging Guidance (Eg Fluoroscopy) And All Associated Radiological Supervision And Interpretation Single Or Multiple(List Separately In Addition To Code For Primary Procedure). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47543. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47543 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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