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 | $3751.00 | 1801992631 - NYU LANGONE HOSPITALS | 133971298 - NYU LANGONE HOSPITALS | NY | General Acute Care Hospital (282N00000X) |
United | C9785 | $14275.00 | 1710927660 - CHIPPENHAM & JOHNSTON-WILLIS HOSPITALS, INC., CJW MEDICAL CENTER | 541779911 | VA | 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 | $8025.00 | 1396739165 - PARKWEST MEDICAL CENTER, PENINSULA DIV PARKWEST MC | 581897274 - (TN) PARKWEST MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | C9785 | $9724.00 | 1467442418 - NORTHWEST TEXAS HEALTHCARE SYSTEM INC, NORTHWEST TEXAS HEALTHCARE SYSTEM | 232238976 | TX | 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 | $14811.00 | 1447359997 - OHIO STATE UNIVERSITY HOSPITALS | 311340739 | OH | General Acute Care Hospital (282N00000X) |
United | C9785 | $9491.00 | 1275536799 - LAFAYETTE GENERAL MEDICAL CENTER INC | 720535375 - (LA) LAFAYETTE GENERAL MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | C9785 | $10119.00 | 1225133473 - MONMOUTH MEDICAL CENTER INC, MONMOUTH MEDICAL CENTER SOUTHERN CAMPUS | 223452412 | NJ | General Acute Care Hospital (282N00000X) |
United | C9785 | $14250.00 | 1558408633 - VANDERBILT UNIVERSITY MEDICAL CENTER, VANDERBILT PSYCHIATRIC HOSPITAL | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | C9785 | $8896.00 | 1255302923 - LEXINGTON HOSPITAL CORPORATION, HENDERSON COUNTY COMMUNITY HOSPITAL | 421557533 | TN | General Acute Care Hospital (282N00000X) |
United | C9785 | $12847.00 | 1063406551 - COUNTY OF SANTA CLARA, INPATIENT ACUTE/OUTPATIENT FACILITY SERVICES | 946000533 | CA | General Acute Care Hospital (282N00000X) |
United | C9785 | $8296.00 | 1942348354 - BAYLOR UNIVERSITY MEDICAL CENTER | 751837454 - (TX) BAYLOR UNIVERSITY MEDICAL CENTER | TX | 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 | $7718.00 | 1710238639 - SAINT CLARE'S HOSPITAL INC | 463483967 | NJ | 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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