HCPCS C7528 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 C7528 by major payers:
$811.95
$N/A
$8,296.15
$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 C7528 | ||||||
United | C7528 | $3687.00 | 1720589328 - PIEDMONT WALTON HOSPITAL INC | 824194264 - (GA) PIEDMONT WALTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C7528 | $6028.00 | 1457396079 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL | 581954432 - (GA) NORTHSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C7528 | $357.00 | 1659363844 - LASER & SURGERY CENTER OF ACADIANA | 721288671 - (LA) LASER SURGERY CENTER OF ACADIANA | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7528 | $7820.00 | 1225050396 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL CHEROKEE | 581954432 - (GA) NORTHSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C7528 | $15822.00 | 1013514199 - KECK MEDICAL CENTER OF USC, KECK HOSPITAL OF USC | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | C7528 | $1762.00 | 1043679327 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, VALLEYWISE HEALTH | 860830701 | AZ | Adult Mental Health Clinic/Center (261QM0850X) |
United | C7528 | $1762.00 | 1770167108 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT | 860830701 | AZ | Multi-Specialty Clinic/Center (261QM1300X) |
United | C7528 | $499.00 | 1811001548 - AMBULATORY SURGERY CENTER OF OPELOUSAS | 721502278 - (LA) AMBULATORY SURGERY CENTER OF O | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7528 | $1762.00 | 1861811614 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, MARICOPA INTEGRATED HEALTH | 860830701 | AZ | Federally Qualified Health Center (FQHC) (261QF0400X) |
United | C7528 | $2304.00 | 1992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS | 262037695 - GRADY MEMORIAL HOSPITAL CORPORATION | GA | General Acute Care Hospital (282N00000X) |
United | C7528 | $1514.00 | 1124710199 - MARICOPA COUNTY SPECIAL HEALLTH CARE DISTRICT, VALLEYWISE HEALTH | 860830701 | AZ | Adult Mental Health Clinic/Center (261QM0850X) |
United | C7528 | $1762.00 | 1427476670 - MARICOPA COUNTY SPECIAL HEALTHCARE DISTRICT, MARICOPA INTEGRATED HEALTH | 860830701 | AZ | Federally Qualified Health Center (FQHC) (261QF0400X) |
United | C7528 | $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 | C7528 | $269.00 | 1811512734 - SSL ENDOSCOPY CENTER LLC, AVALA SURGERY CENTER | 843735506 - (LA) SSL ENDOSCOPY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7528 | $1514.00 | 1629840137 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, VALLEYWISE MOBILE HEALTH CLINIC | 860830701 | AZ | Federally Qualified Health Center (FQHC) (261QF0400X) |
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 C7528 vs. Other Miscellaneous Surgical Procedures Codes
The HCPCS C7528 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 C7528 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 |
|---|---|---|
| C7527-HCPCS | Moderate | Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report |
| C7528-HCPCS | Moderate | Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, with intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (initial coronary vessel or graft) during coronary angiography including pharmacologically induced stress |
| C7529-HCPCS | Moderate | Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography with intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (initial coronary vessel or graft) during coronary angiography including pharmacologically induced stress |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C7528. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C7528 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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