HCPCS C7504 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 | • Outpatient PPS • Miscellaneous Surgical Procedures |
| Complexity Level | High |
National average reimbursement for HCPCS C7504 by major payers:
$1,648.89
$N/A
$10,841.83
$N/A
| 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 HCPCS C7504 | ||||||
United | C7504 | $234.00 | 1801949631 - THIBODAUX SURGERY CENTER, LLC, BAYOU REGION SURGICAL CENTER | 320165642 - (LA) THIBODAUX SURGERY CENTER, LLC DBA BAYOU REGION SURGICAL CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7504 | $290.00 | 1760658256 - HARVARD SURGERY CENTER LLC | 208147301 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7504 | $924.00 | 1992788772 - EAST JEFFERSON AMBULATORY SURGERY CENTER | 201425074 - (LA) EAST JEFFERSON AMBULATORY | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7504 | $2028.00 | 1275536799 - LAFAYETTE GENERAL MEDICAL CENTER INC | 720535375 - (LA) LAFAYETTE GENERAL MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | C7504 | $3939.00 | 1962537407 - BATON ROUGE GENERAL MEDICAL CENTER | 721025017 - (LA) BATON ROUGE GENERAL MEDICAL CENTER | LA | General Acute Care Hospital (282N00000X) |
United | C7504 | $1028.00 | 1104181247 - ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC | 455502071 - (LA) ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7504 | $341.00 | 1700874062 - RIVERSIDE MEDICAL CENTER, RIVERSIDE MEDICAL CENTER | 720629905 - (LA) RIVERSIDE MEDICAL CENTER | LA | Critical Access Hospital (282NC0060X) |
United | C7504 | $7820.00 | 1376574277 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL FORSYTH | 581954432 - (GA) NORTHSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C7504 | $5848.00 | 1497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL | 621596506 | LA | General Acute Care Hospital (282N00000X) |
United | C7504 | $983.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7504 | $748.00 | 1710932470 - HOSPITAL SERVICE DISTRICT NO1 PARISH OF AVOYELLES STATE OF LOUISIANA | 720697593 | LA | Critical Access Hospital (282NC0060X) |
United | C7504 | $890.00 | 1477509859 - PHYSICIANS MEDICAL CENTER, LLC | 721275428 - (LA) PHYSICIANS MEDICAL CENTER, LLC | LA | General Acute Care Hospital (282N00000X) |
United | C7504 | $385.00 | 1306843826 - WEST CARROLL HEALTH SYSTEMS LLC, WEST CARROLL MEMORIAL HOSPITAL | 562300247 - WEST CARROLL HEALTH SYSTEMS L.L.C. | LA | General Acute Care Hospital (282N00000X) |
United | C7504 | $300.00 | 1548233794 - METAIRIE OPHTHALMOLOGY ASC LLC, AMBULATORY EYE SURGERY CENTER OF LOUISIANA | 621822003 - (LA) THE METAIRIE OPHTHALMOLOGY ASC, LLC DBA AMBULATORY EYE SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7504 | $434.00 | 1821250176 - NORTHSHORE AMBULATORY SURGERY CENTER LLC | 800352092 - (LA) NORTHSHORE AMBULATORY SURGERY CENTER LLC | LA | 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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HCPCS C7504 vs. Other Miscellaneous Surgical Procedures Codes
The HCPCS C7504 code is part of the Outpatient PPS services used for Miscellaneous Surgical 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 HCPCS C7504 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 |
|---|---|---|
| C7503-HCPCS | Moderate | Open biopsy or excision of deep cervical node(s) with intraoperative identification (eg, mapping) of sentinel lymph node(s) including injection of non-radioactive dye when performed |
| C7504-HCPCS | High | Percutaneous vertebroplasties (bone biopsies included when performed), first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusive of all imaging guidance |
| C7505-HCPCS | High | Percutaneous vertebroplasties (bone biopsies included when performed), first lumbosacral and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusive of all imaging guidance |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C7504. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C7504 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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