HCPCS C7509 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 | • Outpatient PPS • Miscellaneous Surgical Procedures |
| Complexity Level | Moderate |
National average reimbursement for HCPCS C7509 by major payers:
$211.34
$N/A
$5,309.63
$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 C7509 | ||||||
United | C7509 | $748.00 | 1639377294 - BUNKIE GENERAL HOSPITAL | 720697593 | LA | Critical Access Hospital (282NC0060X) |
United | C7509 | $6577.00 | 1407947336 - CLHG-VILLE PLATTE LLC, MERCY REGIONAL MEDICAL CENTER | 824681222 | LA | General Acute Care Hospital (282N00000X) |
United | C7509 | $1165.00 | 1588654966 - ST. JAMES PARISH HOSP. SERV. DIST. | 726010747 - (LA) ST JAMES PARISH HOSPITAL | LA | Critical Access Hospital (282NC0060X) |
United | C7509 | $363.00 | 1750338620 - BIENVILLE MEDICAL CENTER, INC. | 743227578 | LA | Critical Access Hospital (282NC0060X) |
United | C7509 | $13999.00 | 1396854543 - LIFECARE HOSPITAL OF NEW ORLEANS AT KENNER | 205432782 | LA | General Acute Care Hospital (282N00000X) |
United | C7509 | $2204.00 | 1376591941 - HOSPITAL SERVICE DISTRICT 1 OF EAST BATON ROUGE PARISH, LANE REGIONAL MEDICAL CENTER | 726015227 | LA | General Acute Care Hospital (282N00000X) |
United | C7509 | $625.00 | 1669586376 - JEFFERSON AMBULATORY SURGERY CENTER LLC | 202349222 - (LA) JEFFERSON AMBULATORY SURGERY C | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7509 | $762.00 | 1588784649 - CHRISTUS HEALTH SOUTHWESTERN LOUISIANA, CHRISTUS ST. PATRICK HOSPITAL | 720411322 - (LA) CHRISTUS HEALTH SOUTHWESTERN LOUISIANA | LA | General Acute Care Hospital (282N00000X) |
United | C7509 | $5848.00 | 1497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL | 843390470 - (LA) LCMC HEALTH HOLDINGS INC | LA | General Acute Care Hospital (282N00000X) |
United | C7509 | $3738.00 | 1396761805 - OCHSNER BAYOU LLC, OCHSNER ST. ANNE GENERAL HOSPITAL | 204670876 - (LA) OCHSNER BAYOU, LLC | LA | Critical Access Hospital (282NC0060X) |
United | C7509 | $625.00 | 1669586376 - JEFFERSON AMBULATORY SURGERY CENTER LLC | 202349222 - (LA) JEFFERSON AMBULATORY SURGERY C | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7509 | $11474.00 | 1861650780 - CHILDRENS NATIONAL MEDICAL CENTER | 530196580 - CHILDRENS HOSPITAL | DC | Children's Hospital (282NC2000X) |
United | C7509 | $341.00 | 1700874062 - RIVERSIDE MEDICAL CENTER, RIVERSIDE MEDICAL CENTER | 720629905 - (LA) RIVERSIDE MEDICAL CENTER | LA | Critical Access Hospital (282NC0060X) |
United | C7509 | $425.00 | 1871593269 - ACADIANA SURGERY CENTER, INC. | 721235496 - (LA) ACADIANA SURGERY CENTER INC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7509 | $363.00 | 1134126659 - CALDWELL MEMORIAL HOSPITAL INC | 720878037 - (LA) CALDWELL MEMORIAL HOSPITAL, INC. | LA | General Acute Care Hospital (282N00000X) |
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 C7509 vs. Other Miscellaneous Surgical Procedures Codes
The HCPCS C7509 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 C7509 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 |
|---|---|---|
| C7508-HCPCS | High | Percutaneous vertebral augmentations, first lumbar and any additional thoracic or lumbar vertebral bodies, including cavity creations (fracture reductions and bone biopsies included when performed) using mechanical device (eg, kyphoplasty), unilateral or bilateral cannulations, inclusive of all imaging guidance |
| C7509-HCPCS | Moderate | Bronchoscopy, rigid or flexible, diagnostic with cell washing(s) when performed, with computer-assisted image-guided navigation, including fluoroscopic guidance when performed |
| C7510-HCPCS | Moderate | Bronchoscopy, rigid or flexible, with bronchial alveolar lavage(s), with computer-assisted image-guided navigation, including fluoroscopic guidance when performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C7509. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C7509 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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