HCPCS C9738 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 | Low |
National average reimbursement for HCPCS C9738 by major payers:
$92.58
$N/A
$300.78
$95.47
| 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 C9738 | ||||||
United | C9738 | $1265.00 | 1588640692 - EMORY UNIVERSITY, EMORY UNIVERSITY HOSPITAL | 580566256 - (GA) EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | C9738 | $1072.00 | 1962537407 - BATON ROUGE GENERAL MEDICAL CENTER | 721025017 - (LA) BATON ROUGE GENERAL MEDICAL CENTER | LA | General Acute Care Hospital (282N00000X) |
United | C9738 | $660.00 | 1497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL | 843390470 - (LA) LCMC HEALTH HOLDINGS INC | LA | General Acute Care Hospital (282N00000X) |
United | C9738 | $1737.00 | 1003058728 - PIEDMONT HOSPITAL | 580566213 - (GA) PIEDMONT HEALTHCARE INC | GA | General Acute Care Hospital (282N00000X) |
United | C9738 | $1860.00 | 1992815195 - OCHSNER BAPTIST MEDICAL CENTER | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | C9738 | $404.00 | 1447230388 - OPELOUSAS GENERAL HOSPITAL AUTHORITY | 720708111 | LA | General Acute Care Hospital (282N00000X) |
United | C9738 | $2538.00 | 1821221144 - WEST GEORGIA MEDICAL CENTER, INC., WEST GEORGIA MEDICAL CENTER | 205497506 - (GA) WEST GEORGIA MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | C9738 | $80.00 | 1972770022 - OUTPATIENT EYE SURGERY CENTER | 721098835 - (LA) OUTPATIENT EYE SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9738 | $1860.00 | 1811973100 - OCHSNER CLINIC FOUNDATION, OCHSNER MEDICAL CENTER ACUTE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | C9738 | $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 | C9738 | $1409.00 | 1710097936 - OCHSNER MEDICAL CENTER | 205432782 | LA | General Acute Care Hospital (282N00000X) |
United | C9738 | $3151.00 | 1265486278 - EAST GEORGIA REGIONAL MEDICAL CENTER, LLC, EAST GEORGIA REGIONAL MEDICAL CENTER LLC | 582190713 - (GA) EAST GEORGIA REGIONAL MEDICAL CENTER LLC | GA | General Acute Care Hospital (282N00000X) |
United | C9738 | $204.00 | 1366506826 - AMERICAN LEGION HOSPITAL | 464958152 - (LA) ACADIA GENERAL HOSPITAL INC | LA | General Acute Care Hospital (282N00000X) |
United | C9738 | $809.00 | 1538174347 - LCMC HEALTH HOLDINGS INC, EAST JEFFERSON GENERAL HOSPITAL | 621596506 | LA | General Acute Care Hospital (282N00000X) |
United | C9738 | $1154.00 | 1518924109 - TERREBONNE PARISH HOSPITAL SERVICE DISTRICT #1, TERREBONNE GENERAL MEDICAL CENTER | 720880258 - (LA) TERREBONNE HOSPITAL SERVICE DISTRICT NO 1 | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
HCPCS C9738 vs. Other Other Therapeutic Services and Supplies Codes
The HCPCS C9738 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 C9738 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 |
|---|---|---|
| C9734-HCPCS | Moderate | Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (MR) guidance |
| C9738-HCPCS | Low | Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure) |
| C9739-HCPCS | Moderate | Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C9738. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C9738 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS C9738) and we'll show you how you compare in 15 minutes or less.