CPT 47801 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 |
| Common Modifiers | • None • 51 - Multiple procedures • 80 - Assistant surgeon |
| Complexity Level | High |
| CMS | $1,081.02 Physician Fee Schedule |
National average reimbursement for CPT 47801 by major payers:
$1,435.88
$1,443.72
$1,505.81
$1,779.92
| 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 47801 | ||||||
United | 47801 | $565.00 | 1114965803 - ADVANCED ENDOSCOPY & SURGICAL CENTER LLC, ADVANCED ENDOSCOPY & SURGICAL CENTER | 113660090 - (NJ) ADVANCED ENDOSCOPY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $230.00 | 1316253438 - TREASURE COAST UROLOGY CENTER, LLC | 273328667 - (FL) TREASURE COAST UROLOGY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $565.00 | 1801458989 - MILLENNIUM SURGERY CENTERS OF FLORIDA, LLC | 371911799 - (FL) MILLENNIUM SURGERY CENTERS OF FLORIDA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $352.00 | 1699813774 - LAUREL LASER & SURGERY CENTER, L.P., LAUREL LASER & SURGERY CENTER-ALTOONA | 251852464 - (PA) LAUREL LASER SURGERY CENTER LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $620.00 | 1184897472 - LAKE COUNTRY ENDOSCOPY CENTER, LLC | 261572986 - (WI) LAKE COUNTRY ENDOSCOPY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $693.00 | 1982677191 - LAS VEGAS EAST OPHTHALMOLOGY ASC LLC, SHEPHERD EYE SURGICENTER | 752829740 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $895.00 | 1902070832 - GASTRO OPERATING COMPANY LLC, (DBA) MEADOWBROOK ENDOSCOPY CENTER | 202432134 - (NY) GASTRO OPERATING COMPANY, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $381.00 | 1659360303 - ST JOHNS SURGERY CENTER LLC | 650502027 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $2732.00 | 1962277483 - KC SURGICENTER, LLC | 372003878 - (MO) KC SURGICENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $807.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $600.00 | 1912412420 - GALEA CENTER, LLC., GALEA CENTER FOR ADVANCED SURGERY | 821939476 - (CA) GALEA CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $525.00 | 1801827993 - SOUTH CAROLINA ENDOSCOPY CENTER | 571125931 - (SC) SOUTH CAROLINA ENDOSCOPY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $260.00 | 1831280536 - EFFINGHAM SURGICAL PARTNERS LLC | 371409876 - (IL) EFFINGHAM SURGICAL PARTNERS, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $383.00 | 1467635581 - PREMIER ENDOSCOPY CENTER,LLC | 205055187 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47801 | $442.00 | 1669772893 - ADVANCED EYE SURGERY CENTER, L.L.C. | 273717607 - (KS) ADVANCED EYE SURGERY CENTER LLC | KS | 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 47801 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47801 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 47801 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 |
|---|---|---|
| 47700-CPT | High | Exploration For Congenital Atresia Of Bile Ducts, Without Repair, With Or Without Liver Biopsy, With Or Without Cholangiography |
| 47701-CPT | High | Portoenterostomy (Eg, Kasai Procedure) |
| 47712-CPT | High | Excisn Of Bile Duct Tumor, W/Wo Primary Bile Duct Repair, Intrahepatic |
| 47801-CPT | High | Placement Choledochal Stent |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47801. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47801 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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