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 |
| CMS | $428.59 Physician Fee Schedule |
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 | $1777.00 | 1396771036 - THE GASTROENTEROLOGY CENTER OF VIRGINIA, PLLC | 30426509 - (VA) THE GASTROENTEROLOGY CENTER OF VIRGINIA, PLLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $3753.00 | 1306989249 - MEDICAL ARTS SURGERY CENTER LLC | 208261564 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $4047.00 | 1265401202 - NORTHWEST ORTHOPAEDIC SPECIALISTS, P.S., THE ORTHOPAEDIC SURGERY CENTER | 911502837 - NORTHWEST ORTHOPAEDIC SPECIALISTS, P.S. | WA | 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 | $1500.00 | 1376716316 - CPM SURGERY CENTER LLC | 261382311 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $1650.00 | 1922187103 - NORTH HILLS SURGERY CENTER, LLC, NORTH HILLS SURGERY CENTER | 710807771 - (AR) NORTH HILLS SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $857.00 | 1588797807 - SPOKANE DIGESTIVE DISEASE CENTER, P.S., SOUTH ASC | 911013238 - (WA) SPOKANE DIGESTIVE DISEASE CENTER P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $6492.00 | 1215091087 - CORPUS CHRISTI SURGICARE LTD, CHRISTUS SPOHN TEXAS ORTHOPEDIC CENTER OF EXCELLENCE | 753049514 - (TX) CORPUS CHRISTI SURGICARE LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $407.95 | 1134178569 - ZACHARY EDWARDS | 350593390 - DEACONESS HOSPITAL INC | AL | Certified Registered Nurse Anesthetist (367500000X) |
United | 47554 | $10336.00 | 1093708315 - ASSOCIATED HEALTH SERVICES, INC., JAMES E DAVIS AMBULATORY SURGICAL CENTER | 561845329 - (NC) ASSOCIATED HEALTH SERVICES INC | NC | 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 | $6588.00 | 1184714214 - GAINESVILLE ENDOSCOPY CENTER, LLC | 10750801 - (GA) GAINESVILLE ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $2219.00 | 1629079058 - CARES SURGICENTER LLC | 223557777 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $865.00 | 1295824100 - BETTER LIVING ENDOSCOPY CENTER | 640877920 - (MS) BETTER LIVING ENDOSCOPY CENTER | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47554 | $877.00 | 1801993217 - EYE PHYSICIANS OF SUSSEX COUNTY, EYE PHYSICIANS OF SUSSEX COUNTY SURGICAL SUITE | 222172159 - (NJ) EYE PHYSICIANS OF SUSSEX COUNTY | NJ | 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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