HCPCS C9603 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 C9603 by major payers:
$4,539.04
$54.00
$49.42
$449.20
| 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 C9603 | ||||||
United | C9603 | $136.00 | 1073505616 - THIBODAUX LASER AND SURGERY CENTER, LLC | 364463537 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9603 | $379.00 | 1639377294 - BUNKIE GENERAL HOSPITAL | 720697593 | LA | Critical Access Hospital (282NC0060X) |
United | C9603 | $809.00 | 1295772259 - LAKEVIEW MEDICAL CENTER, LLC, LAKEVIEW REGIONAL MEDICAL CENTER | 621596506 | LA | General Acute Care Hospital (282N00000X) |
United | C9603 | $566.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9603 | $688.00 | 1104181247 - ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC | 455502071 - (LA) ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9603 | $124.00 | 1265437743 - REGIONAL UROLOGY ASC LLC | 721455456 - (LA) REGIONAL UROLOGY ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9603 | $341.00 | 1700874062 - RIVERSIDE MEDICAL CENTER, RIVERSIDE MEDICAL CENTER | 720629905 - (LA) RIVERSIDE MEDICAL CENTER | LA | Critical Access Hospital (282NC0060X) |
United | C9603 | $163.00 | 1861458507 - BRASS PARTNERSHIP IN COMMENDAM | 721097827 - (LA) BRASS PARTNERSHIP IN COMMENDAM | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9603 | $566.00 | 1104181247 - ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC | 455502071 - (LA) ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9603 | $112.00 | 1891763157 - HOUMAS OUTPATIENT SURGERY CENTER | 721005613 - (LA) HOUMA OUTPATIENT SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9603 | $92.00 | 1780865634 - NEW ORLEANS LA UPTOWN WEST BANK ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND TERAPEUTIC CENTER | 205904530 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9603 | $1860.00 | 1528069218 - NORTHSHORE REGIONAL MEDICAL CENTER DBA THE SURGERY SUITE, THE SURGERY SUITE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9603 | $420.00 | 1184697930 - THE ALEXANDRIA OPHTHALMOLOGY ASC LLC, WALLACE LASER AND SURGERY CENTER | 752830937 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9603 | $594.00 | 1861087991 - CRESCENT CITY SURGICAL CENTRE OPERATING COMPANY, L.L.C. | 270508997 - (LA) CRESCENT CITY SURGICAL CENTRE | LA | General Acute Care Hospital (282N00000X) |
United | C9603 | $131.00 | 1598390015 - CHRISTUS SURGERY CENTER VILLAGES LLC, CHRISTUS SURGERY CENTER - SHREVEPORT | 844975265 - (LA) CHRISTUS SURGERY CENTER VILLAGES LLC | 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 C9603 vs. Other Percutaneous Transcatheter/Transluminal Coronary Procedures Codes
The HCPCS C9603 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 C9603 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 |
|---|---|---|
| C9602-HCPCS | High | Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch |
| C9603-HCPCS | High | Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure) |
| C9604-HCPCS | High | Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C9603. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C9603 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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