HCPCS C9761 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 C9761 by major payers:
$415.12
$N/A
$12,014.38
$N/A
| 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 C9761 | ||||||
United | C9761 | $1303.00 | 1881631497 - NEW IBERIA SURGERY CENTER LLC | 721455114 - (LA) NEW IBERIA SURGERY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9761 | $6259.00 | 1063406684 - SAINT JOSEPH'S HOSPITAL, INC. | 580568702 - (GA) SAINT JOSEPHS HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C9761 | $1391.00 | 1912627712 - CENTER FOR ROBOTIC SURGERY OF LOUISIANA LLC | 883537315 - CENTER FOR ROBOTIC SURGERY OF LOUISIANA LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9761 | $13419.00 | 1598766495 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER,INC | 720423635 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | C9761 | $1084.00 | 1811001548 - AMBULATORY SURGERY CENTER OF OPELOUSAS | 721502278 - (LA) AMBULATORY SURGERY CENTER OF O | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9761 | $2690.00 | 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 | C9761 | $5885.00 | 1649248626 - KENNESTONE HOSPITAL, INC., WELLSTAR KENNESTONE HOSPITAL | 582032904 - KENNESTONE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C9761 | $1114.00 | 1154318376 - LAHAYE CENTER FOR ADVANCED EYE CARE OF LAFAYETTE, INC. | 721227426 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9761 | $2927.00 | 1144283292 - LAFAYETTE SURGERY CENTER LIMITED PARTNERSHIP | 943419282 - (LA) LAFAYETTE SURGERY CENTER LIMITED PARTNERSHIP | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9761 | $4454.00 | 1528027240 - FAYETTE COMMUNITY HOSPITAL, INC., PIEDMONT FAYETTE HOSPITAL | 582322328 - (GA) FAYETTE COMMUNITY HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C9761 | $7354.00 | 1396761805 - OCHSNER BAYOU LLC, OCHSNER ST. ANNE GENERAL HOSPITAL | 204670876 - (LA) OCHSNER BAYOU, LLC | LA | Critical Access Hospital (282NC0060X) |
United | C9761 | $3872.00 | 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 | C9761 | $14775.69 | 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 | C9761 | $3991.00 | 1285663856 - ROCKDALE MEDICAL CENTER INC., ROCKDALE HOSPITAL | 300999841 - (GA) PIEDMONT ROCKDALE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C9761 | $10370.36 | 1205833241 - CLHG-WINN, LLC, WINN PARISH MEDICAL CENTER | 813465517 | 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 C9761 vs. Other Other Therapeutic Services and Supplies Codes
The HCPCS C9761 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 C9761 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 |
|---|---|---|
| C9760-HCPCS | High | Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, trans-esophageal echocardiography (tee)/intracardiac echocardiography (ice), and all imaging with or without guidance (e.g., ultrasound, fluoroscopy), performed in an approved investigational device exemption (ide) study |
| C9761-HCPCS | Moderate | Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if applicable (must use a steerable ureteral catheter) |
| C9762-HCPCS | Moderate | Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C9761. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C9761 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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