HCPCS C9728 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 C9728 by major payers:
$491.95
$239.26
$958.32
$714.53
| 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 C9728 | ||||||
United | C9728 | $1510.84 | 1568663920 - PROGRESSIVE ACUTE CARE AVOYELLES, LLC, AVOYELLES HOSPITAL | 813465468 | LA | General Acute Care Hospital (282N00000X) |
United | C9728 | $1882.21 | 1083903744 - HOSPITAL SERVICE DISTRICT OF THE PARISH OF ST. BERNARD, STATE OF LOUIS, ST. BERNARD PARISH HOSPITAL | 261576974 - (LA) HOSPITAL SERVICE DISTRICT OF THE PARISH OF ST BERNARD STATE OF LOUIS | LA | Rural Acute Care Hospital (282NR1301X) |
United | C9728 | $2128.76 | 1396520862 - LAKE SURGICAL HOSPITAL SLIDELL, LLC | 474228147 - (LA) LAKE SURGICAL HOSPITAL SLIDELL, LLC DBA SOUTHERN SURGICAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | C9728 | $2186.30 | 1093140600 - OUR LADY OF THE ANGELS HOSPITAL, INC., OUR LADY OF THE ANGELS HOSPITAL | 463123178 - (LA) OUR LADY OF THE ANGELS HOSPITAL INC | LA | General Acute Care Hospital (282N00000X) |
United | C9728 | $1661.93 | 1144274127 - PROGRESSIVE ACUTE CARE DAUTERIVE, LLC, DAUTERIVE HOSPITAL | 364756243 - (LA) PROGRESSIVE ACUTE CARE DAUTERIVE LLC | LA | General Acute Care Hospital (282N00000X) |
United | C9728 | $2779.95 | 1578568481 - SLIDELL MEMORIAL HOSPITAL, ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT #2 | 726014895 - (LA) SLIDELL MEMORIAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | C9728 | $946.09 | 1902465065 - THIBODAUX REGIONAL HEALTH SYSTEM INC | 842046902 - (LA) THIBODAUX REGIONAL HEALTH SYSTEM INC | LA | General Acute Care Hospital (282N00000X) |
United | C9728 | $1534.45 | 1205833241 - CLHG-WINN, LLC, WINN PARISH MEDICAL CENTER | 813465517 | LA | General Acute Care Hospital (282N00000X) |
United | C9728 | $976.32 | 1568461572 - WILLIS KNIGHTON MEDICAL CENTER, INC. | 720400933 - (LA) WILLIS-KNIGHTON MEDICAL CENTER | LA | General Acute Care Hospital (282N00000X) |
United | C9728 | $3023.06 | 1114976263 - SLIDELL MEMORIAL HOSPITAL, MD IMAGING SLIDELL | 726014895 - (LA) SLIDELL MEMORIAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | C9728 | $1631.71 | 1992720791 - OMEGA HOSPITAL LLC | 470901008 - (LA) OMEGA HOSPITAL, LLC | LA | General Acute Care Hospital (282N00000X) |
United | C9728 | $1641.86 | 1043392491 - DOCTORS' HOSPITAL OF SLIDELL, LLC, STERLING SURGICAL HOSPITAL | 522363244 - (LA) DOCTORS HOSPITAL OF SLIDELL, LLC | LA | General Acute Care Hospital (282N00000X) |
United | C9728 | $3070.30 | 1578568481 - SLIDELL MEMORIAL HOSPITAL, ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT #2 | 726014895 - (LA) SLIDELL MEMORIAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | C9728 | $954.21 | 1821098286 - TOURO INFIRMARY | 720423659 - (LA) TOURO INFIRMARY | LA | General Acute Care Hospital (282N00000X) |
United | C9728 | $2128.76 | 1821465576 - LAKE SURGICAL HOSPITAL SLIDELL, LLC, SOUTHERN SURGICAL HOSPITAL | 474228147 - (LA) LAKE SURGICAL HOSPITAL SLIDELL, LLC DBA SOUTHERN SURGICAL HOSPITAL | 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 C9728 vs. Other Other Therapeutic Services and Supplies Codes
The HCPCS C9728 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 C9728 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 |
|---|---|---|
| C9727-HCPCS | Moderate | Insertion of implants into the soft palate; minimum of three implants |
| C9728-HCPCS | Moderate | Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperitoneum, thorax, single or multiple |
| C9733-HCPCS | Low | Non-ophthalmic fluorescent vascular angiography |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C9728. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C9728 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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