HCPCS C8003 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | Outpatient PPS Extraarticular Knee Implants |
| Complexity Level | High |
National average reimbursement for HCPCS C8003 by major payers:
$1,609.33
$N/A
$2,102.22
$N/A
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | C8003 | $950.00 | 1316970916 - SURGICAL SPECIALTY CENTER, LLC | 721418824 - (LA) SURGICAL SPECIALTY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C8003 | $14976.00 | 1780690180 - HOSPITAL SERVICE DISTRICT NO. 1 OF IBERIA PARISH, IBERIA MEDICAL CENTER | 726014963 | LA | General Acute Care Hospital (282N00000X) |
United | C8003 | $11271.00 | 1275536799 - LAFAYETTE GENERAL MEDICAL CENTER INC | 720535375 - (LA) LAFAYETTE GENERAL MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | C8003 | $385.00 | 1306843826 - WEST CARROLL HEALTH SYSTEMS LLC, WEST CARROLL MEMORIAL HOSPITAL | 562300247 - WEST CARROLL HEALTH SYSTEMS L.L.C. | LA | General Acute Care Hospital (282N00000X) |
United | C8003 | $3996.00 | 1366506826 - AMERICAN LEGION HOSPITAL | 464958152 - (LA) ACADIA GENERAL HOSPITAL INC | LA | General Acute Care Hospital (282N00000X) |
United | C8003 | $625.00 | 1669586376 - JEFFERSON AMBULATORY SURGERY CENTER LLC | 202349222 - (LA) JEFFERSON AMBULATORY SURGERY C | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C8003 | $341.00 | 1144227935 - CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE, TRINITY MEDICAL | 720578642 - (LA) RIVERLAND MEDICAL CENTER | LA | Critical Access Hospital (282NC0060X) |
United | C8003 | $14823.00 | 1164750840 - CENTRAL LOUISIANA SURGICAL HOSPITAL LLC, CHRISTUS CENTRAL LOUISIANA SURGICAL HOSPITAL | 264732898 - (LA) CENTRAL LOUISIANA SURGICAL HOSPITAL, LLC | LA | General Acute Care Hospital (282N00000X) |
United | C8003 | $7803.00 | 1093793408 - JACKSON PARISH HOSPITAL, JACKSON PARISH HOSPITAL | 720549907 | LA | Critical Access Hospital (282NC0060X) |
United | C8003 | $2185.00 | 1831183748 - HOMER MEMORIAL HOSPITAL, CLAIBORNE MEMORIAL MEDICAL CENTER | 720396868 - (LA) HOMER MEMORIAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | C8003 | $1862.00 | 1760696546 - ST CHARLES PARISH HOSPITAL | 726014606 | LA | General Acute Care Hospital (282N00000X) |
United | C8003 | $41032.00 | 1043533706 - OCHSNER MEDICAL CENTER, OCHSNER MEDICAL CENTER - NORTHSHORE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | C8003 | $354.00 | 1245215706 - SOUTHSIDE FOOT CLINIC OF SHREVEPORT INC A PROFESSIONAL CORPORATION, THE FOOT SURGERY CENTER OF SHREVEPORT | 721198169 - (LA) SOUTHSIDE FOOT CLINIC OF SHREVEPORT INC A PROFESSIONAL CORPORATION | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C8003 | $9610.00 | 1265437644 - WEST JEFFERSON HOLDINGS, LLC, WEST JEFFERSON MEDICAL CENTER | 472667968 - WEST JEFFERSON HOLDINGS, LLC | LA | General Acute Care Hospital (282N00000X) |
United | C8003 | $8093.00 | 1538174347 - LCMC HEALTH HOLDINGS INC, EAST JEFFERSON GENERAL HOSPITAL | 621596506 | 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 C8003 vs. Other Extraarticular Knee Implants Codes
The HCPCS C8003 code is part of the Outpatient PPS services used for Extraarticular Knee Implants. 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 C8003 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 |
|---|---|---|
| C8003-HCPCS | High | Implantation of medial knee extraarticular implantable shock absorber spanning the knee joint from distal femur to proximal tibia, open, includes measurements, positioning and adjustments, with imaging guidance (eg, fluoroscopy) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C8003. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C8003 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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