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See a sample rate comparisonCPT 49187 Fee Schedule
Last Verified: October 2026
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.
Opn Exc/Dstr Ntra-Abd 5.1-10, Excision Or Destruction Open Intra-Abdominal (Ie Peritoneal Mesenteric Retroperitoneal) Primary Or Secondary Tumor(S) Or Cyst(S) Sum Of The Maximum Length Of Tumor(S) Or Cyst(S); 5.1 To 10 Cm
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 49187 |
| Medicaid Fee Schedule | View Medicaid rates for 49187 |
National average reimbursement for CPT 49187 by major payers:
$2,396.59
$3,417.45
$1,222.86
$2,549.38
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CPT 49187
5 of 25 sample ratesHigher to lower in this preview
Park Ridge Surgery Center, LLC
Park Ridge Surgery Center LLC
$2,785.00Published rateDmg Surgical Center LLC, Surgical Center Of Dupage Medical Group
$1,137.00Published rateSacred Heart Asc, LLC
Sacred Heart Asc LLC
$840.00Published rateNational Surgical Centers Of America LLC, Nscoa
National Surgical Centers Of America LLC
$510.00Published ratePlymouth Laser Center, P.C., Plymouth Laser & Surgical Center
Plymouth Laser Center PC
$122.00Published rate
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See a sample payer proposalCPT 49187 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49187 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 49187 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 |
|---|---|---|
| 49187-CPT | High | Opn Exc/Dstr Ntra-Abd 5.1-10, Excision Or Destruction Open Intra-Abdominal (Ie Peritoneal Mesenteric Retroperitoneal) Primary Or Secondary Tumor(S) Or Cyst(S) Sum Of The Maximum Length Of Tumor(S) Or Cyst(S); 5.1 To 10 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49187. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49187 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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