CPT 47720 Fee Schedule
Healthcare 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 • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • GC - Service performed by resident under supervision • 58 - Staged or related procedure during postoperative period • 22 - Increased Procedural Services • 51 - Multiple procedures • 78 - Return to OR - related procedure • TC - Technical component • XS - Separate Structure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 47720 |
National average reimbursement for CPT 47720 by major payers:
$1,326.80
$1,523.93
$1,584.03
$1,870.84
| 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 47720 | ||||||
United | 47720 | $1064.00 | 1881697522 - RIVERSIDE PARK SURGICENTER LLC | 593106055 - (FL) RIVERSIDE PARK SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $732.00 | 1427005313 - WESTERN WASHINGTON MEDICAL GROUP, INC PS, WESTERN WASHINGTON MEDICAL GROUP ENDOSCOPY CENTER | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $609.00 | 1730614330 - GYPSY LANE ENDOSCOPY SUITES, INC. | 475672535 - (OH) GYPSY LANE ENDOSCOPY SUITES INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $469.00 | 1386858595 - ALDERWOOD SURGERY CENTER LLC | 204979154 - (WA) ALDERWOOD SURGICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $553.00 | 1346912250 - SOUTHEAST EYE LASER SURGERY CENTER | 853785035 - (GA) SOUTHEAST EYE LASER SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $475.00 | 1083299747 - IRVING SPECIALISTS SURGICAL CENTER LLC | 852271899 - (TX) IRVING SPECIALISTS SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $709.00 | 1023271459 - RIVERBEND AMBULATORY SURGERY CENTER LLC, DAY SURGERY AT RIVERBEND | 205575145 - (OR) RIVERBEND AMBULATORY SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $1188.00 | 1730500935 - BARDMOOR SURGERY CENTER LLC, BARDMOOR SURGERY CENTER | 204385452 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $2416.00 | 1205364981 - MERCED AMBULATORY SURGERY CENTER, LLC, UNIVERSITY SURGERY CENTER | 611845381 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $413.00 | 1891784955 - PLATTSBURGH ASC LLC, CATARACT CETNER FOR THE ADIRONDACKS | 141801168 - (NY) PLATTSBURGH ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $516.00 | 1073546875 - STRAND GASTROINTESTINAL ENDOSCOPY CENTER | 571082826 - (SC) STRAND GASTROINTESTINAL ENDOSCOPY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $2000.00 | 1245862002 - QUINCY PHYSICIANS & SURGEONS CLINIC, PLLC, QUINCY MEDICAL GROUP SURGERY CENTER | 371206525 - QUINCY PHYSICIANS & SURGEONS CLINIC S.C. D/B/A QUINCY MEDICAL GROUP | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $362.00 | 1528053311 - AMERICAN ENDOSCOPY CENTER, P.C. | 593795864 - (TN) AMERICAN ENDOSCOPY CENTER PC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $900.00 | 1386381408 - CYPRESS AMBULATORY SURGERY CENTER, LLC, WELLNESS AVENUE SURGERY CENTER | 823481913 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47720 | $425.00 | 1972156842 - NORMAN REGIONAL HOSPITAL AUTHORITY, MEDICAL PLAZA ENDOSCOPY | 736048282 | OK | 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 47720 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47720 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 47720 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 |
|---|---|---|
| 47620-CPT | High | Cholecystectomy With Exploration Of Common Duct; With Transduodenal Sphincterotomy Or Sphincteroplasty, With Or Without Cholangiography |
| 47700-CPT | High | Exploration For Congenital Atresia Of Bile Ducts, Without Repair, With Or Without Liver Biopsy, With Or Without Cholangiography |
| 47720-CPT | High | Cholecystoenterosotomy;Direct |
| 47721-CPT | High | Cholecystoenterostomy W Gastroenter |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47720. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47720 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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