HCPCS C9785 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | High |
National average reimbursement for HCPCS C9785 by major payers:
$2,120.82
$N/A
$49.42
$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 C9785 | ||||||
United | C9785 | $8578.00 | 1275566200 - BANNER ESTRELLA MEDICAL CENTER | 900065118 - (AZ) BANNER ESTRELLA MEDICAL CENTER | AZ | General Acute Care Hospital (282N00000X) |
United | C9785 | $14177.00 | 1972557957 - ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP, NORTH AUSTIN MEDICAL CENTER | 742781812 | TX | General Acute Care Hospital (282N00000X) |
United | C9785 | $17167.00 | 1992131320 - MONTEFIORE MOUNT VERNON HOSPITAL | 462916938 - (NY) MONTEFIORE MOUNT VERNON HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | C9785 | $13041.00 | 1366465866 - LONGMONT UNITED HOSPITAL, LONGMONT UNITED HOSPITAL | 840460697 - LONGMONT UNITED HOSPITAL | CO | General Acute Care Hospital (282N00000X) |
United | C9785 | $13730.00 | 1801867643 - AHS CUSHING HOSPITAL LLC, CUSHING REGIONAL HOSPITAL | 201024792 - (OK) AHS CUSHING HOSPITAL LLC | OK | General Acute Care Hospital (282N00000X) |
United | C9785 | $3475.00 | 1053354100 - LONG ISLAND COMMUNITY HOSPITAL AT NYU LANGONE HEALTH, LONG ISLAND COMMUNITY HOSPITAL | 111704595 - (NY) LONG ISLAND COMMUNITY HOSPITAL AT NYU LANGONE HEALTH | NY | General Acute Care Hospital (282N00000X) |
United | C9785 | $7961.00 | 1659559573 - ST LUKES COMMUNITY DEVELOPMENT CORPORATION, ST LUKES SUGAR LAND HOSPITAL | 261947374 - (TX) ST LUKES COMMUNITY DEVELOPMENT CORPORATION-SUGAR LAND | TX | General Acute Care Hospital (282N00000X) |
United | C9785 | $2973.00 | 1811068646 - GREAT RIVER MEDICAL CENTER | 716042625 - (AR) MISSISSIPPI COUNTY HOSPITAL SYSTEM | AR | General Acute Care Hospital (282N00000X) |
United | C9785 | $14317.00 | 1124272547 - ADVOCATE CONDELL MEDICAL CENTER | 262525968 - (IL) ADVOCATE HEALTH CARE NETWORK | IL | General Acute Care Hospital (282N00000X) |
United | C9785 | $14085.00 | 1467702514 - EMANUEL MEDICAL CENTER, INC., EMANUEL FAMILY PRACTICE | 752918774 | CA | General Acute Care Hospital (282N00000X) |
United | C9785 | $3007.00 | 1871918870 - PROSPECT CHARTERCARE SJHSRI, LLC, OUR LADY OF FATIMA HOSPITAL | 464661337 | RI | General Acute Care Hospital (282N00000X) |
United | C9785 | $3348.00 | 1790701787 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF CARDIOLOGY, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | C9785 | $11077.00 | 1831330075 - JOHNSTON MEMORIAL HOSPITAL | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | General Acute Care Hospital (282N00000X) |
United | C9785 | $11265.00 | 1861078651 - ST VINCENTS HEALTH SYSTEM INC, ASCENSION ST VINCENT'S ST. JOHNS COUNTY | 593650609 - (FL) ST VINCENTS HEALTH SYSTEM INC | FL | General Acute Care Hospital (282N00000X) |
United | C9785 | $43080.00 | 1366404428 - BON SECOURS-RICHMOND COMMUNITY HOSPITAL LLC, BON SECOURS - RICHMOND COMMUNITY HOSPITAL | 540647482 | VA | 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 C9785 vs. Other Other Therapeutic Services and Supplies Codes
The HCPCS C9785 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 C9785 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 |
|---|---|---|
| C9784-HCPCS | High | Gastric restrictive procedure, endoscopic sleeve gastroplasty, with esophagogastroduodenoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components |
| C9785-HCPCS | High | Endoscopic outlet reduction, gastric pouch application, with endoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components |
| C9786-HCPCS | Moderate | Echocardiography image post processing for computer aided detection of heart failure with preserved ejection fraction, including interpretation and report |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C9785. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C9785 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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