CPT 47999 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 • GC - Service performed by resident under supervision • 51 - Multiple procedures |
| Complexity Level | High |
National average reimbursement for CPT 47999 by major payers:
$1,024.62
$251.91
$1,279.50
$894.50
| 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 47999 | ||||||
United | 47999 | $428.00 | 1104220466 - ELITE SURGERY CENTER LLC | 320411327 - (PA) ELITE SURGERY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $1179.00 | 1659772648 - SURGICAL SPECIALTY CENTER OF MID ATLANTIC, LLC | 465727021 - (MD) SURGICAL SPECIALTY CENTER OF MID-ATLANTIC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $1695.92 | 1417944778 - MERRIMACK VALLEY ENDOSCOPY CENTER | 43578297 - (MA) MERRIMACK VALLEY ENDOSCOPY CENTER | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $785.00 | 1235683798 - ASSOCIATED SURGICAL CENTER LLC | 813492018 - (IL) ASSOCIATED SURGICAL CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $774.00 | 1346868890 - UPNT SURGERY LLC | 371939831 - (TX) UPNT SURGERY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $1666.00 | 1477584621 - HANOVER NJ ENDOSCOPY ASC LLC, HANOVER ENDOSCOPY CENTER | 201272329 - (NJ) HANOVER NJ ENDOSCOPY ASC LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $5532.00 | 1629032446 - AMBULATORY SURGERY CENTER GROUP LTD | 592073099 - (FL) AMBULATORY SURGERY CENTER GROUP LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $939.00 | 1891175188 - PHOENIX SPINE GOODYEAR ASC, LLC, PHOENIX SPINE SURGERY CENTER | 853605981 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $402.00 | 1659356392 - LASER & CATARACT CENTER OF SHREVEPORT LLC, EYE SURGERY CENTER | 721382751 - (LA) LASER CATARACT CENTER OF SHREVEPORT LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $1276.00 | 1235395385 - TENN SM LLC | 680569923 - (TN) TENN SM LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $1114.00 | 1912460015 - PREMIER EYE SURGERY CENTER OF COLORADO, LLC, PREMIER EYE SURGERY CENTER | 823760640 - (CO) PREMIER EYE SURGERY CENTER OF COLORADO, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $1597.00 | 1154322410 - SUMMIT SURGICAL SUITES, LLC, SOUTHWEST SURGICAL SUITES | 383641574 - (IN) SUMMIT SURGICAL SUITES LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $489.00 | 1104199413 - BARNET DULANEY PERKINS EYE CENTER, PC, BDPEC SUN CITY | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $2382.00 | 1184752305 - SEASHORE SURGICAL INSTITUTE, LLC | 223660141 - (NJ) SEASHORE SURGICAL INSTITUTE | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 47999 | $347.00 | 1033223367 - SOUTHEASTERN OUTPATIENT SURGERY CENTER LLC | 201379958 - (FL) SOUTHEASTERN OUTPATIENT SURGERY CENTER LLC | FL | 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 47999 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47999 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 47999 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 |
| 47740-CPT | High | Cholecystoenterostomy; Roux-En-Y |
| 47999-CPT | High | Unlisted Procedure Biliary Tract |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47999. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47999 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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