CPT 49185 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 | Excision and Destruction Procedures on the Abdomen, Peritoneum, and Omentum Surgical Procedures on the Abdomen, Peritoneum, and Omentum |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 59 - Distinct Procedural Service GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 49185 |
National average reimbursement for CPT 49185 by major payers:
$1,238.25
$1,462.14
$1,675.70
$324.83
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 49185 | $300.00 | 1033115472 - CAPLAN-BERKELEY, LLP, CAPLAN SURGERY CENTER | 571146952 - (TX) CAPLANBERKELEY LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $560.00 | 1891875175 - HEAD AND NECK SURGICAL PARTNERS LLC | 911824787 - (NE) HEAD AND NECK SURGICAL PARTNERS LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $951.00 | 1932162195 - COVENANT HIGH PLAINS SURGERY CENTER, LLC, COVENANT HIGH PLAINS SURGERY CENTER - QUAKER AVENUE | 752177401 - (TX) COVENANT HIGH PLAINS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $275.00 | 1083206866 - FIANNA HILLS SURGERY CENTER INC | 845048943 - (AR) FIANNA HILLS SURGERY CENTER INC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $1595.00 | 1215211552 - PUTNAM GI, LLC, PUTNAM ENDOSCOPY ASC, LLC | 274431591 - (NY) PUTNAM GI LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $295.00 | 1760196984 - JACKSON HEART AND VASCULAR CENTER LLC | 870947298 - (MS) JACKSON HEART AND VASCULAR CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $1392.00 | 1689832438 - INOVA WOODBURN SURGERY CENTER LLC | 540620889 - INOVA HEALTH CARE SERVICES | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $953.00 | 1912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $967.00 | 1366559122 - HARVARD PARK SURGERY CENTER, LLC, HARVARD PARK SURGERY CENTER | 331107194 - (CO) HARVARD PARK SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $528.00 | 1881031235 - KEARNEY PAIN TREATMENT CENTER, LLC | 461807684 - (NE) KEARNEY PAIN TREATMENT CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $368.00 | 1073030532 - AKDHC SURGERY CENTER, LLC | 753052504 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $539.00 | 1073758298 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, BAPTIST HEALTH ENDOSCOPY CENTER AT GALLOWAY NORTH | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $412.00 | 1407801509 - ATLANTIC SURGERY CENTER,LLC | 223625894 - (NJ) ATLANTIC SURGERY CENTERLLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $572.00 | 1720085384 - ELMHURST OUTPATIENT SURGERY CENTER LLC | 364150045 - (IL) ELMHURST OUTPATIENT SURGERY CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49185 | $2350.00 | 1376790691 - MEMORIAL HERMANN ENDOSCOPY & SURGERY CENTER NORTH HOUSTON, LLC, NORTH HOUSTON ENDOSCOPY & SURGERY CENTER | 262809136 | TX | 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 49185 vs. Other Surgical Procedures on the Abdomen, Peritoneum, and Omentum Codes
The CPT 49185 code is part of the Excision and Destruction Procedures on the Abdomen, Peritoneum, and Omentum services used for Surgical Procedures on the Abdomen, Peritoneum, and Omentum. 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 49185 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 |
|---|---|---|
| 49020-CPT | High | Drain Infection From Abdomen, Surgery To Drain Abscess (Pocket Of Infection) Located In The Peritoneum (Lining Of The Abdominal Cavity). |
| 49082-CPT | Moderate | Remove Fluid From Abdomen, A Procedure To Remove Excess Fluid That Has Accumulated In The Abdomen. In Some Cases Scans Are Used To Help View The Area. |
| 49083-CPT | Moderate | Remove Fluid From Abdomen, A Procedure To Remove Excess Fluid That Has Accumulated In The Abdomen. In Some Cases Scans Are Used To Help View The Area. |
| 49185-CPT | High | Sclerotx Fluid Collection, 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 49185. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49185 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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