CPT 47554 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • GC - Service performed by resident under supervision • AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 47554 |
National average reimbursement for CPT 47554 by major payers:
$605.46
$682.23
$684.56
$786.13
| 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 47554 | ||||||
United | 47554 | $412.00 | 1598093007 - TARBORO ENDOSCOPY CENTER, LLC | 271345858 - (NC) TARBORO ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $3114.00 | 1811940141 - SOUTHPARK SURGERY CENTER LLC, SOUTHPARK SURGERY CENTER | 870714098 - (NC) SOUTHPARK SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $3836.00 | 1922160357 - ARAPAHOE ENDOSCOPY CENTER PARTNERSHIP PLLP | 472388780 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $7888.00 | 1912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $7888.00 | 1134431323 - BETHESDA CHEVY CHASE SURGERY CENTER, LLC | 272875760 - (MD) BETHESDA CHEVY CHASE SURGERY CEN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $3247.00 | 1508574518 - AMBULATORY SURGERY CENTER OF CENTRALIA | 883961418 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $2601.00 | 1265435614 - ANMED HEALTH MEDICUS SURGERY CENTER LLC, MEDICUS SURGERY CENTER, INC. | 542189833 - (SC) ANMED HEALTH MEDICUS SURGERY CENTER, LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $4704.00 | 1093383655 - SHERMAN ENDOSCOPY CENTER, LLC | 861402910 - (TX) SHERMAN ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $4500.00 | 1609223056 - HEART HEALTH CENTER, LLC | 473280746 - (AZ) HEART HEALTH CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $1390.00 | 1619049939 - ENDOSCOPY CENTER MONROE LLC, CAROLINA ENDOSCOPY CENTER MONROE | 260731594 - (NC) ENDOSCOPY CENTER MONROE LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $3056.00 | 1669050654 - HEART & VASCULAR AMBULATORY SURGERY CENTER, LLC | 862335325 - (FL) HEART VASCULAR AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $2339.00 | 1659360303 - ST JOHNS SURGERY CENTER LLC | 650502027 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $10126.00 | 1528521887 - NOVANT HEALTH CLEMMONS OUTPATIENT SURGERY, LLC | 825250651 - (NC) NOVANT HEALTH CLEMMONS OUTPATIENT SURGERY LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $1886.00 | 1528153111 - MECHANICSVILLE AMBULATORY SURGERY CENTER, LLC | 200767912 - (MD) MECHANICSVILLE AMBULATORY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $1922.00 | 1477848992 - VASCARE | 275431592 - (WI) VASCARE MAYFAIR LLC | WI | 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 47554 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47554 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 47554 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 |
|---|---|---|
| 47550-CPT | Moderate | Biliary Endoscopy,Intraoperative |
| 47552-CPT | Moderate | Biliary Endoscopy Percutaneous Via T-Tube Or Other Tract; Diagnostic With Collection Of Specimen(S) By Brushing And/Or Washing When Performed (Separate Procedure) (Revised 01/01/2014) |
| 47553-CPT | Moderate | Biliary Endoscopy;Bx/Collec Spec |
| 47554-CPT | Moderate | Choledochoscopy Percut - Rem Stone |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47554. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47554 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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