CPT 48547 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 • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 78 - Return to OR - related procedure • 80 - Assistant surgeon • 22 - Increased Procedural Services |
| Complexity Level | High |
| CMS | $1,744.45 Physician Fee Schedule |
National average reimbursement for CPT 48547 by major payers:
$2,268.16
$2,373.24
$2,463.77
$2,892.99
| 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 48547 | ||||||
United | 48547 | $200.00 | 1194271338 - CONROE ASC, LP, COLLEGE PARK HEART & VASCULAR SURGERY CENTER | 471450737 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $1049.00 | 1649223124 - CAMP LOWELL SURGERY CENTER,LLC, CAMP LOWELL SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $1049.00 | 1821342858 - SURGCENTER OF ORANGE PARK, LLC, ORANGE PARK ENDOSCOPY CENTER | 460858710 - (FL) SURGCENTER OF ORANGE PARK LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $390.00 | 1982676227 - THE PALMETTO ASC, LLC, THE PALMETTO SURGERY CENTER | 621647406 - (FL) THE PALMETTO SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $200.00 | 1922193515 - MAHONING VALLEY AMBULATORY SURGERY CENTER INC | 233056394 - (PA) MAHONING VALLEY AMBULATORY SURGERY CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $500.00 | 1922178169 - IMPERIAL HEALTH, LLP | 721005645 - (LA) IMPERIAL HEALTH, LLP | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $412.00 | 1508879446 - WEST FLORIDA SURGERY CENTER INC | 651092124 - (FL) WEST FLORIDA SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $97.00 | 1992735286 - CASTLEMAN SURGERY CENTER, LLC, SOUTHGATE SURGERY CENTER | 383029505 - (MI) CASTLEMAN SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $1049.00 | 1598083594 - MID-STATE ENDOSCOPY CENTER LLC | 270673692 - (TN) MIDSTATE ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $523.00 | 1669181822 - ALLIANCE SURGERY CENTER AT CUMMING | 881953675 - (GA) ALLIANCE SURGERY CENTER AT CUMMING | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $750.00 | 1881620466 - MIDLANDS ORTHOPAEDICS SURGERY CENTER, LLC | 203345412 - (SC) MIDLANDS ORTHOPAEDICS SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $1064.00 | 1477700516 - SUMMIT AMBULATORY SURGICAL CENTER LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $649.00 | 1104897644 - FOX VALLEY ORTHOPAEDIC ASSOCIATES, S.C., FOX VALLEY ORTHOPAEDIC AMBULATORY SURGICAL CENTER | 362796281 - FOX VALLEY ORTHOPAEDIC ASSOCIATES, S.C. | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $991.00 | 1467907287 - OPTUM CARE WASHINGTON PLLC, THE EDMONDS SURGERY CENTER | 910214500 - THE EVERETT CLINIC, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48547 | $700.00 | 1093156937 - QUALITY CARE SURGERY CENTER, LLC | 462355538 - (CA) QUALITY CARE SURGERY CENTER LLC | CA | 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 48547 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48547 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 48547 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 |
|---|---|---|
| 48148-CPT | High | Exc Ampulla Vater Simple |
| 48154-CPT | High | Pancreatectomy Proximal Subtotal With Near-Total Duodenectomy Choledochoenterostomy And Duodenojejunostomy (Pylorus-Sparing Whipple-Type Procedure); Without Pancreatojejunostomy |
| 48545-CPT | High | Pancreatorraphy For Trauma |
| 48547-CPT | High | Duodenal Exclusion With Gastrojejunostomy For Pancreatic Trauma |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48547. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48547 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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