CPT 75959 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Diagnostic Radiology (Diagnostic Imaging) Procedures |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • 26 - Professional component • None • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
National average reimbursement for CPT 75959 by major payers:
$265.35
$861.11
$214.02
$302.19
| 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 75959 | ||||||
United | 75959 | $449.33 | 1780335901 - ELIZABETH SUAREZ | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Physician Assistant (363A00000X) |
United | 75959 | $318.35 | 1144849993 - MIRANDA ANDERSON | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
United | 75959 | $843.69 | 1366400376 - SUNRISE HOME HEALTH CARE INC. | 650307774 - (FL) SUNRISE HOME HEALTH CARE INC | FL | Home Health Agency (251E00000X) |
United | 75959 | $758.71 | 1457972853 - ROBERT PASQUINI | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Physician Assistant (363A00000X) |
United | 75959 | $758.71 | 1124029764 - STEVEN HOLMAN | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 75959 | $758.71 | 1326394859 - DANIELLA PINHO | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 75959 | $1208.06 | 1629137831 - RADIOLOGY ASSOCIATES OF NORTH TEXAS COUNTY PA | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Ultrasound Physician (2085U0001X) |
United | 75959 | $215.80 | 1013915149 - BAYCARE HOME CARE, INC., DBA SARASOTA MEMORIAL HOME CARE | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 75959 | $449.33 | 1639123870 - MITA MAJMUNDAR | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 75959 | $150.00 | 1043795347 - BRIAN HONEKAMP | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Nurse Practitioner (363L00000X) |
United | 75959 | $3508.90 | 1841443975 - MOHAMAD HABOUKH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 75959 | $449.33 | 1417303405 - MARK WINTER | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 75959 | $150.02 | 1508827536 - THOMAS HAYES | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 75959 | $215.82 | 1851390637 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 75959 | $1208.06 | 1457447120 - STEVEN LUTZKER | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
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 75959 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 75959 code is part of the Radiology Procedures services used for Diagnostic Radiology (Diagnostic Imaging) Procedures. 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 75959 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 |
|---|---|---|
| 75885-CPT | Low | Perc Trnshep Portgraphy W/Hemo S&I |
| 75902-CPT | Low | Mechanical Removal Of Intraluminal (Intracatheter) Obstructive Material From Central Venous Device Through Device Lumen, Radiologic Supervision And Interpretation |
| 75956-CPT | Moderate | Endovascular Repair Of Descending Thoracic Aorta (Eg Aneurysm Pseudoaneurysm Dissection Penetrating Ulcer Intramural Hematoma Or Traumatic Disruption); Involving Coverage Of Left Subclaviann Artery Origin Initial Endoprosthesis Plus Descending Thoracic Aortic Extension(S) If Required To Level Of Celiac Artery Origin Radiological Supervision And Interpretation |
| 75959-CPT | Moderate | Placement Of Distal Extension Prosthesis(S) (Delayed) After Endovascular Repair Of Descending Thoracic Aorta, As Needed, To Level Of Celiac Origin, Radiological Supervision And Interpretation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 75959. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 75959 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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