CPT 47785 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 • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • 80 - Assistant surgeon • 22 - Increased Procedural Services |
| Complexity Level | High |
| CMS | $3,131.79 Physician Fee Schedule |
National average reimbursement for CPT 47785 by major payers:
$3,975.53
$4,174.96
$4,490.68
$5,117.06
| 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 47785 | ||||||
United | 47785 | $852.00 | 1609872597 - COLISEUM SAME DAY SURGERY CENTER LP | 621805346 - (GA) COLISEUM SAME DAY SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $690.00 | 1992765986 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, WALDRON ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $1492.00 | 1457379158 - HUDSON CROSSING SURGERY CENTER, LLC, HUDSON CROSSING SURGERY CENTER | 364533553 - (NJ) HUDSON CROSSING SURGICAL CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $381.00 | 1093766289 - CAPITAL WOMENS CARE LLC, FREDERICK OB/GYN AMBULATORY SURGERY CENTER | 522112078 - (MD) CAPITAL WOMENS CARE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $800.00 | 1760869093 - ORTHOPEDIC AMBULATORY SURGERY CENTER OF CHESTERFIELD, LLC | 473506918 - (MO) ORTHOPEDIC AMBULATORY SURGERY CENTER OF CHESTERFIELD LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $565.00 | 1447661145 - ADVANCED OUTPATIENT SURGERY OF OKLAHOMA, LLC | 371751472 - (OK) ADVANCED OUTPATIENT SURGERY OF | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $1050.00 | 1508400920 - NAZARETH ENDOSCOPY CENTER, LLC | 824072967 - (PA) NAZARETH ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $949.00 | 1144648015 - SANSUM CLINIC, FOOTHILL SURGERY CENTER AT SANSUM CLINIC | 956419205 - (CA) SANSUM CLINIC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $4893.00 | 1558331801 - MEMORIAL HERMANN SURGERY CENTER, MEMORIAL HERMANN SURGERY CENTER, THE WOODLANDS | 201765863 - (TX) MEMORIAL HERMANN SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $670.00 | 1619998648 - PAIN CARE CENTER BOISE, LLC, PAIN CARE BOISE | 200197438 - (ID) PAIN CARE CENTER BOISE, L.L.C. | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $492.00 | 1538432844 - BARNET DULANEY PERKINS EYE CENTER, PC, AMERICAN VISION PARTNERS | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $1064.00 | 1992706899 - SURGERY CENTER OF PEORIA, LLC, SURGERY CENTER OF PEORIA | 731538768 - (AZ) SURGERY CENTER OF PEORIA LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $675.00 | 1932496908 - CONCOURSE DIAGNOSTIC SURGERY CENTER, LLC, CONCOURSE DIAGNOSTIC SURGERY CENTER,LLC | 273205326 - (CA) CONCOURSE DIAGNOSTIC & SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $535.00 | 1588638688 - MASONICARE HEALTH CENTER | 60655131 - (CT) MASONICARE HEALTH CENTER | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47785 | $1559.00 | 1548280209 - SHORT HILLS SURGERY CENTER, LLC, SHORT HILLS SURGERY CENTER | 721572665 - (NJ) SHORT HILLS SURGERY CENTER, LLC | 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 47785 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47785 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 47785 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47785. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47785 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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