HCPCS C9601 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 • Percutaneous Transcatheter/Transluminal Coronary Procedures |
| Complexity Level | High |
National average reimbursement for HCPCS C9601 by major payers:
$4,367.14
$54.00
$1,456.48
$1,405.56
| 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 C9601 | ||||||
United | C9601 | $124.00 | 1265437743 - REGIONAL UROLOGY ASC LLC | 721455456 - (LA) REGIONAL UROLOGY ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9601 | $695.00 | 1730761065 - BURKE HOSPITAL COMPANY, BURKE HEALTH | 853939331 - BURKE HOSPITAL COMPANY, LLC | GA | General Acute Care Hospital (282N00000X) |
United | C9601 | $215.00 | 1588648315 - POINTE COUPEE PARISH HEALTH SERVICES DISTRICT NUMBER ONE, POINTE COUPEE GENERAL HOSPITAL | 721054801 | LA | Critical Access Hospital (282NC0060X) |
United | C9601 | $2538.00 | 1386664779 - WELLSTAR SYLVAN GROVE HOSPITAL, INC, SYLVAN GROVE HOSPITAL | 810875069 - (GA) WELLSTAR SYLVAN GROVE HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | C9601 | $495.00 | 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 | C9601 | $1473.00 | 1992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS | 262037695 - GRADY MEMORIAL HOSPITAL CORPORATION | GA | General Acute Care Hospital (282N00000X) |
United | C9601 | $1860.00 | 1811973100 - OCHSNER CLINIC FOUNDATION, OCHSNER MEDICAL CENTER ACUTE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | C9601 | $340.00 | 1215996632 - PARK PLACE SURGERY CENTER, LLC, PARK PLACE SURGICAL HOSPITAL | 721404092 - (LA) PARK PLACE SURGICAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | C9601 | $136.00 | 1891126728 - STONEBRIDGE HEALTH SYSTEMS, LLC, SOUTH CAMERON MEMORIAL HOSPITAL | 464145136 - (LA) STONEBRIDGE HEALTH SYSTEMS LLC | LA | Rural Acute Care Hospital (282NR1301X) |
United | C9601 | $1856.00 | 1780643411 - PIEDMONT MOUNTAINSIDE HOSPITAL, INC., PIEDMONT MOUNTAINSIDE HOSPITAL | 352228583 - (GA) PIEDMONT MOUNTAINSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C9601 | $80.00 | 1801949631 - THIBODAUX SURGERY CENTER, LLC, BAYOU REGION SURGICAL CENTER | 320165642 - (LA) THIBODAUX SURGERY CENTER, LLC DBA BAYOU REGION SURGICAL CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9601 | $412.00 | 1831193499 - HOSPITAL SERVICE DISTRICT NO 2 OF PARISH OF BEAUREGARD STATE OF LA, BEAUREGARD MEMORIAL HOSPITAL | 720491106 - WEST LOUISIANA HEALTH SERVICES INC | LA | Rural Acute Care Hospital (282NR1301X) |
United | C9601 | $112.00 | 1891763157 - HOUMAS OUTPATIENT SURGERY CENTER | 721005613 - (LA) HOUMA OUTPATIENT SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9601 | $2333.00 | 1851362263 - BLUE RIDGE GEORGIA HOSPITAL COMPANY LLC, FANNIN REGIONAL HOSPITAL | 760350464 | GA | General Acute Care Hospital (282N00000X) |
United | C9601 | $1189.00 | 1407947336 - CLHG-VILLE PLATTE LLC, MERCY REGIONAL MEDICAL CENTER | 824681222 | 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 C9601 vs. Other Percutaneous Transcatheter/Transluminal Coronary Procedures Codes
The HCPCS C9601 code is part of the Outpatient PPS services used for Percutaneous Transcatheter/Transluminal Coronary 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 C9601 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 |
|---|---|---|
| C9600-HCPCS | High | Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch |
| C9601-HCPCS | High | Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure) |
| C9602-HCPCS | High | Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C9601. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C9601 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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