HCPCS C7539 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 C7539 by major payers:
$783.56
$N/A
$31,311.17
$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 C7539 | ||||||
United | C7539 | $1694.00 | 1063525442 - STATE OF NEW YORK COMPTROLLERS OFFICE, HELEN HAYES HOSPITAL | 146013200 - STATE OF NY UNIFIED COURT SYSTEM | NY | General Acute Care Hospital (282N00000X) |
United | C7539 | $420.00 | 1184697930 - THE ALEXANDRIA OPHTHALMOLOGY ASC LLC, WALLACE LASER AND SURGERY CENTER | 752830937 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7539 | $457.00 | 1891772547 - NOVAMED SURGERY CENTER OF BATON ROUGE LLC, INTERVENTIONAL PAIN MANAGEMENT CENTER | 262609309 - (LA) NOVAMED SURGERY CENTER OF BATON ROUGE LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7539 | $547.00 | 1881631497 - NEW IBERIA SURGERY CENTER LLC | 721455114 - (LA) NEW IBERIA SURGERY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7539 | $457.00 | 1891772547 - NOVAMED SURGERY CENTER OF BATON ROUGE LLC, INTERVENTIONAL PAIN MANAGEMENT CENTER | 262609309 - (LA) NOVAMED SURGERY CENTER OF BATON ROUGE LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7539 | $884.00 | 1598390015 - CHRISTUS SURGERY CENTER VILLAGES LLC, CHRISTUS SURGERY CENTER - SHREVEPORT | 844975265 - (LA) CHRISTUS SURGERY CENTER VILLAGES LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7539 | $556.00 | 1134427297 - SURGERY CENTER OF ZACHARY, LLC | 811928790 - (LA) SURGERY CENTER OF ZACHARY, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7539 | $7002.00 | 1780643411 - PIEDMONT MOUNTAINSIDE HOSPITAL, INC., PIEDMONT MOUNTAINSIDE HOSPITAL | 352228583 - (GA) PIEDMONT MOUNTAINSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C7539 | $1694.00 | 1538276530 - STATE OF NEW YORK COMPTROLLERS OFFICE, HELEN HAYES HOSPITAL | 146013200 - STATE OF NY UNIFIED COURT SYSTEM | NY | Skilled Nursing Facility (314000000X) |
United | C7539 | $13834.00 | 1093009151 - USC UNIVERSITY HOSPITAL | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | C7539 | $13834.00 | 1093009151 - USC UNIVERSITY HOSPITAL | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | C7539 | $1694.00 | 1962858316 - STATE OF NEW YORK COMPTROLLERS OFFICE, HELEN HAYES HOSPITAL TCU | 146013200 - STATE OF NY UNIFIED COURT SYSTEM | NY | Skilled Nursing Facility (314000000X) |
United | C7539 | $1762.00 | 1629840137 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, VALLEYWISE MOBILE HEALTH CLINIC | 860830701 | AZ | Federally Qualified Health Center (FQHC) (261QF0400X) |
United | C7539 | $683.00 | 1134590912 - SLENT INVESTMENTS, LLC, SLENT SURGERY CENTER | 472307119 - (LA) SLENT INVESTMENTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7539 | $1514.00 | 1003273855 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, MARICOPA SPECIAL HEALTH CARE DISTRICT | 860830701 | AZ | Adult Mental Health Clinic/Center (261QM0850X) |
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 C7539 vs. Other Miscellaneous Surgical Procedures Codes
The HCPCS C7539 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 C7539 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 |
|---|---|---|
| C7538-HCPCS | Moderate | Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defribrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) |
| C7539-HCPCS | Moderate | Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) |
| C7540-HCPCS | Moderate | Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C7539. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C7539 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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