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 |
| CMS | $366.81 Physician Fee Schedule |
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 | $379.64 | 1871925057 - DEWEY DRISCOLL | 350593390 - DEACONESS HOSPITAL INC | ID | Certified Registered Nurse Anesthetist (367500000X) |
United | 47543 | $379.64 | 1336541275 - WILLIAM SALINAS | 350593390 - DEACONESS HOSPITAL INC | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | 47543 | $826.29 | 1437107521 - ROBERT STARRETT | 350593390 - DEACONESS HOSPITAL INC | IN | Interventional Cardiology Physician (207RI0011X) |
United | 47543 | $826.29 | 1497381438 - BERNARD NDEDI | 350593390 - DEACONESS HOSPITAL INC | IL | Emergency Medicine Physician (207P00000X) |
United | 47543 | $826.29 | 1598739617 - AMJAD ALI | 350593390 - DEACONESS HOSPITAL INC | KY | Internal Medicine Physician (207R00000X) |
United | 47543 | $826.29 | 1457302564 - KENNETH PARKER | 350593390 - DEACONESS HOSPITAL INC | IN | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 47543 | $826.29 | 1124439864 - TATIANA DENEGA | 350593390 - DEACONESS HOSPITAL INC | TX | Hospitalist Physician (208M00000X) |
United | 47543 | $826.29 | 1124150685 - DAVID FISH | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
United | 47543 | $826.29 | 1467415117 - MARLON JORDAN | 350593390 - DEACONESS HOSPITAL INC | IL | Cardiovascular Disease Physician (207RC0000X) |
United | 47543 | $379.64 | 1972030351 - JAMIE MARKSBERRY | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 47543 | $379.64 | 1245800671 - DONNY LE | 350593390 - DEACONESS HOSPITAL INC | PA | Certified Registered Nurse Anesthetist (367500000X) |
United | 47543 | $379.64 | 1962481515 - CLARIZEL YARBROUGH | 350593390 - DEACONESS HOSPITAL INC | KY | Certified Registered Nurse Anesthetist (367500000X) |
United | 47543 | $2178.28 | 1801813266 - GREGG BEAN | 741671142 - (TX) SOUTH TEXAS RADIOLOGY GROUP, P.A. | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 47543 | $826.29 | 1386664852 - HIRAK SEN | 350593390 - DEACONESS HOSPITAL INC | FL | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | 47543 | $3077.00 | 1053361642 - DEACONESS HOSPITAL, INC. | 350593390 - DEACONESS HOSPITAL INC | IN | General Acute Care Hospital (282N00000X) |
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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