HCPCS C9769 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 C9769 by major payers:
$334.11
$N/A
$5,791.46
$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 C9769 | ||||||
United | C9769 | $5847.00 | 1457396079 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL | 581954432 - (GA) NORTHSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C9769 | $5847.00 | 1952340994 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL GWINNETT | 581954432 - (GA) NORTHSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C9769 | $2307.00 | 1437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC | 453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9769 | $532.00 | 1811228083 - MESQUITE SURGERY CENTER LLC | 270170010 - (AZ) MESQUITE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9769 | $532.00 | 1811228083 - MESQUITE SURGERY CENTER LLC | 270170010 - (AZ) MESQUITE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9769 | $832.00 | 1417957796 - ENDOSCOPY CENTER OF MONROE | 721130603 - (LA) ENDOSCOPY CENTER OF MONROE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9769 | $5847.00 | 1790715381 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL DULUTH | 581954432 - (GA) NORTHSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C9769 | $3343.00 | 1780643411 - PIEDMONT MOUNTAINSIDE HOSPITAL, INC., PIEDMONT MOUNTAINSIDE HOSPITAL | 352228583 - (GA) PIEDMONT MOUNTAINSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C9769 | $2307.00 | 1104181247 - ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC | 455502071 - (LA) ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9769 | $3213.00 | 1992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS | 262037695 - GRADY MEMORIAL HOSPITAL CORPORATION | GA | General Acute Care Hospital (282N00000X) |
United | C9769 | $6304.00 | 1437186111 - PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC. | 582179986 - (GA) PIEDMONT ATHENS REGIONAL MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | C9769 | $5054.00 | 1982600540 - UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC., PIEDMONT MCDUFFIE HOSPITAL | 454166209 - (GA) UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | C9769 | $5928.00 | 1275527889 - CANDLER HOSPITAL INCORPORATED | 580593388 - CANDLER HOSPITAL INCORPORATED | GA | General Acute Care Hospital (282N00000X) |
United | C9769 | $3512.00 | 1780643411 - PIEDMONT MOUNTAINSIDE HOSPITAL, INC., PIEDMONT MOUNTAINSIDE HOSPITAL | 352228583 - (GA) PIEDMONT MOUNTAINSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C9769 | $3985.00 | 1760498588 - PIEDMONT NEWTON HOSPITAL, INC., NEWTON MEDICAL CENTER | 582155150 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | 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 C9769 vs. Other Other Therapeutic Services and Supplies Codes
The HCPCS C9769 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 C9769 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 |
|---|---|---|
| C9768-HCPCS | Moderate | Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure) |
| C9769-HCPCS | Moderate | Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts |
| C9770-HCPCS | Low | Vitrectomy, mechanical, pars plana approach, with subretinal injection of pharmacologic/biologic agent |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C9769. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C9769 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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