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 | $100.00 | 1922178169 - IMPERIAL HEALTH, LLP | 721005645 - (LA) IMPERIAL HEALTH, LLP | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9601 | $414.00 | 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 | C9601 | $5479.00 | 1841701562 - NAVICENT HEALTH BALDWIN, INC, NAVICENT HEALTH BALDWIN | 823914925 - (GA) NAVICENT HEALTH BALDWIN | GA | General Acute Care Hospital (282N00000X) |
United | C9601 | $2476.00 | 1962435792 - HOUSTON HOSPITALS INC, HOUSTON MEDICAL CENTER | 711045290 - (GA) HOUSTON HOSPITALS INC | GA | General Acute Care Hospital (282N00000X) |
United | C9601 | $2333.00 | 1851362263 - BLUE RIDGE GEORGIA HOSPITAL COMPANY LLC, FANNIN REGIONAL HOSPITAL | 760350464 | GA | General Acute Care Hospital (282N00000X) |
United | C9601 | $1858.00 | 1285663856 - ROCKDALE MEDICAL CENTER INC., ROCKDALE HOSPITAL | 300999841 - (GA) PIEDMONT ROCKDALE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C9601 | $19442.00 | 1598719643 - COLISEUM MEDICAL CENTER, LLC, PIEDMONT MACON MEDICAL CENTER | 621736983 - (GA) COLISEUM MEDICAL CENTER LLC | GA | General Acute Care Hospital (282N00000X) |
United | C9601 | $1488.00 | 1962403865 - DEKALB MEDICAL CENTER, INC., EMORY HILLANDALE HOSPITAL | 581966795 - (GA) EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | C9601 | $27992.00 | 1306355680 - PIEDMONT ROCKDALE HOSPITAL INC. | 300999841 - (GA) PIEDMONT ROCKDALE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C9601 | $2924.00 | 1235417288 - SOUTHEASTERN REGIONAL MEDICAL CENTER, INC., SOUTHEASTERN REGIONAL MEDICAL CENTER, LLC | 264572436 - (GA) SOUTHEASTERN REGIONAL MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | C9601 | $2278.00 | 1952340994 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL GWINNETT | 581954432 - (GA) NORTHSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
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 | $69.00 | 1558475210 - SURGICAL SPECIALTY ASSOCIATES LLC, DOCTORS SAME DAY SURGERY CENTER LLC | 721459017 - (LA) SURGICAL SPECIALTY ASSOCIATES | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9601 | $341.00 | 1306849617 - WEST ASCENSION PARISH HOSPITAL SERVICE DISTRICT, PREVOST MEMORIAL HOSPITAL | 720637478 | LA | Critical Access Hospital (282NC0060X) |
United | C9601 | $19440.00 | 1255401519 - THE MEDICAL CENTER INC, PIEDMONT COLUMBUS REGIONAL MIDTOWN | 581685139 - (GA) THE MEDICAL CENTER INC | GA | 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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