CPT 49084 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 | • Surgery • Surgical Procedures on the Digestive System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Low |
| CMS | $104.16 Physician Fee Schedule |
National average reimbursement for CPT 49084 by major payers:
$142.21
$147.00
$149.03
$186.06
| 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 CPT 49084 | ||||||
United | 49084 | $595.00 | 1285381004 - THE NEBRASKA AMBULATORY SURGICAL CENTER, LLC, THE NEBRASKA AMBULATORY SURGICAL CENTER | 872477902 - (NE) THE NEBRASKA AMBULATORY SURGICAL CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $311.00 | 1336184027 - EYE SURGICENTER LLC | 651005108 - (FL) EYE SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $605.00 | 1760445928 - ARIZONA ENDOSCOPY CENTER, LLC | 860908400 - (AZ) ARIZONA ENDOSCOPY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $3188.00 | 1306472063 - THE EMORY CLINIC INC, EMORY ENDOSCOPY CENTER AT DECATUR | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $3776.00 | 1881678662 - SURGERY AFFILIATE OF EL PASO, LLC, FOUNDATION SURGERY AFFILIATE OF EL PASO, LLC | 742797719 - (TX) SURGERY AFFILIATE OF EL PASO LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $1258.00 | 1881013142 - ADVANCED SURGERY CENTER OF TAMPA, LLC | 463891843 - (FL) ADVANCED SURGERY CENTER OF TAMPA, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $589.00 | 1174571970 - DCR SURGERY CENTER, LLC | 200019313 - (OH) DCR SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $1938.00 | 1437427333 - TOWER CLOCK SURGERY CENTER LLC | 453636581 - (WI) TOWER CLOCK SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $957.00 | 1124086608 - LUTHERAN CAMPUS ASC LLC, THE SURGERY CENTER AT LUTHERAN | 20749532 - (CO) LUTHERAN CAMPUS ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $490.00 | 1588631832 - SURGICAL SERVICES OF MICHIGAN, LLC, BLAKE WOODS MEDICAL PARK | 383234723 - (MI) BLAKE WOODS MEDICAL PARK | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $516.00 | 1306957485 - FAIRFAX COLON & RECTAL SURGERY CENTER, LLC | 510571797 | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $800.00 | 1225523970 - BURNSVILLE SURGERY CENTER, P.A. | 830965169 - (MN) BURNSVILLE SURGERY CENTER PA | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $1886.00 | 1710940218 - DENVER MID-TOWN SURGERY CENTER LTD | 752548180 - DENVER MIDTOWN SURGERY CENTER LTD | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $500.00 | 1598952061 - ENDOSCOPY ASSOCIATES, LLC | 142006705 - (VA) ENDOSCOPY ASSOCIATES LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49084 | $487.00 | 1033210760 - CARLISLE ENDOSCOPY CENTER, LTD. | 251871866 - (PA) CARLISLE ENDOSCOPY CENTER LTD | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
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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CPT 49084 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49084 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 49084 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 |
|---|---|---|
| 49082-CPT | Moderate | Once Per Dos Abdominal Paracentesis (Diagnostic Or Therapeutic); W/O Imaging Guidance |
| 49083-CPT | Moderate | Once Per Dos Abdominal Paracentesis (Diagnostic Or Therapeutic); W/Imaging Guidance |
| 49084-CPT | Low | Once Per Dos Peritoneal Lavage, Including Imaging Guidance, When Performed |
| 49185-CPT | High | Sclerotherapy Of A Fluid Collection (Eg Lymphocele Cyst Or Seroma) Percutaneous Including Contrast Injection(S) Sclerosant Injection(S) Diagnostic Study Imaging Guidance (Eg Ultrasound Fluoroscopy) And Radiological Supervision And Interpretation When Performed. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49084. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49084 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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