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See a sample rate comparisonHCPCS C7565 Fee Schedule
Last Verified: October 2026
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.
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
| 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
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HCPCS C7565
5 of 25 sample ratesHigher to lower in this preview
Ochsner Medical Center, Ochsner Medical Complex - River Parishes
$13,999.00Published rateNorthshore Regional Medical Center Dba The Surgery Suite, The Surgery Suite
Ochsner Clinic Foundation
$4,765.00Published rateOchsner Lsu Health Shreveport, Ochsner Lsu Health Shreveport - St. Mary Medical Center
Ochsner Lsu Health Shreveport
$1,858.00Published rateFranklin Parish Hospital Service District No1, Franklin Medical Center
Franklin Medical Center Employee Benefit Plan Trust
$520.00Published rateSt Helena Parish Hospital, St Helena Parish Hospital
St Helena Parish Hospital
$341.00Published rate
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See a sample payer proposalHCPCS 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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