HCPCS C7565 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 C7565 by major payers:
$392.10
$N/A
$2,102.22
$N/A
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | C7565 | $1862.00 | 1295716637 - HOSPITAL SERVICE DIST. NO. 1 OF THE PARISH OF ST. CHARLES, STATE OF LA, ST. CHARLES PARISH HOSPITAL | 726014606 | LA | General Acute Care Hospital (282N00000X) |
United | C7565 | $653.00 | 1871235770 - SPINE CENTER OF EXCELLENCE LLC, SPINE CENTER OF EXCELLENCE | 861734777 - (LA) SPINE CENTER OF EXCELLENCE LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7565 | $398.00 | 1134300080 - METAIRIE LA ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND THERAPEUTIC CENTER-METAIRIE | 205904530 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7565 | $7168.00 | 1497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL | 621596506 | LA | General Acute Care Hospital (282N00000X) |
United | C7565 | $13593.00 | 1801299375 - OCHSNER MEDICAL CENTER, OCHSNER MEDICAL COMPLEX - RIVER PARISHES | 205432782 | LA | Critical Access Hospital (282NC0060X) |
United | C7565 | $425.00 | 1023542339 - BATON ROUGE VASCULAR ACCESS ASC LLC | 814685509 - (LA) BATON ROUGE VASCULAR ACCESS ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7565 | $1789.00 | 1962024026 - CLHG-RUSTON LLC | 844422249 | LA | General Acute Care Hospital (282N00000X) |
United | C7565 | $2028.00 | 1275536799 - LAFAYETTE GENERAL MEDICAL CENTER INC | 720535375 - (LA) LAFAYETTE GENERAL MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | C7565 | $920.00 | 1588631311 - SURGICAL SPECIALTY CENTER OF BATON ROUGE, LLC, SURGICAL SPECIALTY CENTER OF BATON ROUGE | 263120962 - (LA) SURGICAL SPECIALTY CENTER OF BATON ROUGE, LLC | LA | General Acute Care Hospital (282N00000X) |
United | C7565 | $341.00 | 1013068808 - ST HELENA PARISH HOSPITAL, ST HELENA PARISH HOSPITAL | 720627145 - (LA) ST HELENA PARISH HOSPITAL | LA | Critical Access Hospital (282NC0060X) |
United | C7565 | $4765.00 | 1811973100 - OCHSNER CLINIC FOUNDATION, OCHSNER MEDICAL CENTER ACUTE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | C7565 | $614.00 | 1497090740 - OLOL PONTCHARTRAIN SURGERY CENTER, LLC, OUR LADY OF THE LAKE PONTCHARTRAIN SURGERY CENTER | 461379031 - (LA) OLOL PONTCHARTRAIN SURGERY CENTE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7565 | $383.00 | 1073505616 - THIBODAUX LASER AND SURGERY CENTER, LLC | 364463537 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C7565 | $5729.00 | 1831209048 - OCHSNER MEDICAL CENTER- WESTBANK | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | C7565 | $497.00 | 1598804486 - SHREVEPORT SURGERY CENTER PTRSHP | 721126552 - (LA) SHREVEPORT SURGERY CENTER OF CADDO PARISH, INC. | 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 C7565 vs. Other Miscellaneous Surgical Procedures Codes
The HCPCS C7565 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 C7565 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 |
|---|---|---|
| C7565-HCPCS | Moderate | Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s) less than 3 cm, reducible with removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C7565. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C7565 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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