Data Platform
Sign InTry for Free

CPT 49002 Fee Schedule

Last Verified: November 2025

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.

Reopen Recent Laparotomy Incision
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

58 - Staged or related procedure during postoperative period

78 - Return to OR - related procedure

Complexity LevelHigh
CMS$1,016.33 Physician Fee Schedule

National average reimbursement for CPT 49002 by major payers:

bcbs

$1,279.29

uhc

$1,352.13

aetna

$1,510.57

cigna

$1,665.47

Preview provider-level rates for...
For billing codeCPT 49002
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 49002

United
49002$2100.001164811923 - SHRINERS HOSPITALS FOR CHILDREN, SHRINERS HOSPITALS FOR CHILDREN AMBULATORY SURGERY CENTER-LEXINGTON362193608 - SHRINERS HOSPITALS FOR CHILDRENKYAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$1723.001366137440 - SURGERY CENTER OF GEORGETOWN, LLC, GEORGETOWN SURGERY CENTER880604963 - (TX) SURGERY CENTER OF GEORGETOWN LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$1390.001306833009 - SOUTH BROWARD ENDOSCOPY L L C113685842FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$175.001497367262 - SNKS ENTERPRISES LLC, SOL VALLEY SURGERY CENTER364932587 - (AZ) SNKS ENTERPRISES LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$4893.001366776106 - MEMORIAL HERMANN SURGERY CENTER RICHMOND, LLC, MEMORIAL HERMANN SURGERY CENTER RICHMOND270552583TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$285.001730382789 - ENDOSCOPY CENTER260317060 - (NC) ENDOSCOPY CENTERNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$482.001427020213 - TOLEDO ENDOSCOPY ASC LLC, NORTHWEST OHIO ENDOSCOPY CENTER621734002 - (OH) TOLEDO ENDOSCOPY ASC LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$1416.001750517561 - CANON CITY CO MULTI SPECIALTY ASC LLC, ARKANSAS VALLEY SURGERY CENTER264730485 - (CO) CANON CITY CO MULTI SPECIALTY ASC LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$316.001447218433 - LIBERTY EYE SURGICAL CENTER LLC200054137 - (PA) LIBERTY EYE SURGICAL CENTER, LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$200.001730169657 - LEO R. MCCAFFERTY, M.D., SURGICAL CENTER200421646PAAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$558.001962467951 - GADSDEN SURGERY CENTER LP621488653 - (AL) GADSDEN SURGERY CENTER LPALAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$520.001740918887 - ORTHOMIDWEST SURGERY CENTER BELOIT, LLC881260648 - (WI) ORTHOMIDWEST SURGERY CENTER BELOIT LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$505.001063427706 - PROHEALTH AMBULATORY SURGERY CENTER INC113447394 - (NY) PROHEALTH AMBULATORY SURGERY CENTER INCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$500.001881101335 - BROWN MEDICINE, BROWN MEDICINE ENDOSCOPY CENTER50450410 - BROWN MEDICINERIAmbulatory Surgical Clinic/Center (261QA1903X)
United
49002$293.001972658706 - FREDERICKTOWN AMBULATORY SURGICAL FACILITY, INC.521935764 - (MD) FREDERICKTOWN AMBULATORY SURGICAL FACILITY INCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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.

CPT 49002 vs. Other Surgical Procedures on the Digestive System Codes

The CPT 49002 code is part of the Surgery services used for Surgical Procedures on the Digestive System. 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 CPT 49002 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.

CodeComplexityDescription
49000-CPTModerateLaparotomy/Celiotomy Exploratory
49002-CPTHighReopen Recent Laparotomy Incision
49010-CPTHighExplore,Retroperitoneal Area W/Wo Bx-Sep
49020-CPTHighDrain Absc/Local Inflam Peritoneal

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49002. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 49002 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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like CPT 49002) and we'll show you how you compare in 15 minutes or less.