HCPCS C9726 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Outpatient PPS • Other Therapeutic Services and Supplies |
| Complexity Level | Moderate |
National average reimbursement for HCPCS C9726 by major payers:
$313.00
$54.00
$1,252.53
$691.16
| 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 C9726 | ||||||
United | C9726 | $79.00 | 1144216847 - RIVER PARK ASC LLC | 721510504 - (LA) RIVER PARK ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9726 | $1064.00 | 1275536799 - LAFAYETTE GENERAL MEDICAL CENTER INC | 720535375 - (LA) LAFAYETTE GENERAL MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | C9726 | $434.00 | 1114929957 - OPHTHALMIC OUTPATIENT SURGERY CENTER PARTNERS, LLC, OUTPATIENT SURGERY CENTER FOR SIGHT | 721405960 - (LA) OPHTHALMIC OUTPATIENT SURGERY CENTER PARTNERS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9726 | $2819.00 | 1720133234 - OCHSNER BAYOU, LLC, OCHSNER ST ANNE GENERAL HOSPITAL | 204670876 - (LA) OCHSNER BAYOU, LLC | LA | Critical Access Hospital (282NC0060X) |
United | C9726 | $83.00 | 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 | C9726 | $764.00 | 1881665164 - CLHG-LEESVILLE, BYRD REGIONAL HOSPITAL | 824337635 | LA | General Acute Care Hospital (282N00000X) |
United | C9726 | $293.00 | 1851487086 - FAIRWAY MEDICAL CENTER, LLC, AVALA | 721426390 - (LA) FAIRWAY MEDICAL CENTER, LLC DBA AVALA | LA | General Acute Care Hospital (282N00000X) |
United | C9726 | $660.00 | 1497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL | 843390470 - (LA) LCMC HEALTH HOLDINGS INC | LA | General Acute Care Hospital (282N00000X) |
United | C9726 | $679.00 | 1437574191 - | 464090110 - (LA) OIL CENTER SURGICAL PLAZA | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9726 | $723.00 | 1821098286 - TOURO INFIRMARY | 720423659 - (LA) TOURO INFIRMARY | LA | General Acute Care Hospital (282N00000X) |
United | C9726 | $1484.00 | 1801299375 - OCHSNER MEDICAL CENTER, OCHSNER MEDICAL COMPLEX - RIVER PARISHES | 205432782 | LA | Critical Access Hospital (282NC0060X) |
United | C9726 | $177.00 | 1134126659 - CALDWELL MEMORIAL HOSPITAL INC | 720878037 - (LA) CALDWELL MEMORIAL HOSPITAL, INC. | LA | General Acute Care Hospital (282N00000X) |
United | C9726 | $70.00 | 1386793370 - SURGERY CENTER OF WEST MONROE, LLC | 721509507 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9726 | $721.00 | 1417950106 - CHRISTUS HEALTH NORTHERN LOUISIANA, CHRISTUS SHREVEPORT-BOSSIER HEALTH SYSTEM | 720408982 - (LA) CHRISTUS HEALTH NORTHERN LOUISIANA | LA | General Acute Care Hospital (282N00000X) |
United | C9726 | $405.00 | 1326016684 - NORTH CADDO HOSPITAL SERVICE DISTRICT, NORTH CADDO MEDICAL CENTER | 720594537 - (LA) NORTH CADDO HOSPITAL SERVICE DISTRICT | LA | Critical Access Hospital (282NC0060X) |
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 C9726 vs. Other Other Therapeutic Services and Supplies Codes
The HCPCS C9726 code is part of the Outpatient PPS services used for Other Therapeutic Services and Supplies. 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 C9726 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 |
|---|---|---|
| C9725-HCPCS | Low | Placement of endorectal intracavitary applicator for high intensity brachytherapy |
| C9726-HCPCS | Moderate | Placement and removal (if performed) of applicator into breast for intraoperative radiation therapy, add-on to primary breast procedure |
| C9727-HCPCS | Moderate | Insertion of implants into the soft palate; minimum of three implants |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C9726. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C9726 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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