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See a sample rate comparisonCPT 49255 Fee Schedule
Last Verified: October 2026
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.
Omentectomy Epiploectomy Resct Of Omentum (Sepa Proc), Omentectomy Epiploectomy Resection Of Omentum (Separate Procedure)
| 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 49255 |
| Medicaid Fee Schedule | View Medicaid rates for 49255 |
National average reimbursement for CPT 49255 by major payers:
$976.30
$1,045.16
$1,089.39
$1,267.66
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CPT 49255
5 of 25 sample ratesHigher to lower in this preview
Summit Orthopedic Surgery Center, LLC, Sosc
Summit Orthopedic Surgery Center LLC
$6,874.00Published rateSuburban Endoscopy Center, LLC, Suburban Endoscopy Center
Suburban Endoscopy Center LLC
$2,388.00Published rateTidelands Health Asc LLC, Tidelands Health Surgery Center At The Market Common
Tidelands Health Asc LLC
$1,776.00Published rateGastroenterology Associates Of Fairfield PC, Endoscopy Center Of Fairfield
Gastroenterology Associates Of Fairfield, P.C.
$965.00Published rateEast Valley Endoscopy LLC
East Valley Endoscopy, PLLC
$774.00Published rate
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See a sample payer proposalCPT 49255 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49255 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 49255 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 |
|---|---|---|
| 49000-CPT | Moderate | Exploratory Laparotomy Explor, Exploratory Laparotomy Exploratory Celiotomy Withorwithout Biopsy(S) (Separate Procedure) Explora Tory Laparotomy Exploratory Celiotomy With Or |
| 49255-CPT | Moderate | Omentectomy Epiploectomy Resct Of Omentum (Sepa Proc), Omentectomy Epiploectomy Resection Of Omentum (Separate Procedure) |
| 49320-CPT | Moderate | Laparoscopy Surgical Abdomen, Laparoscopy Surgical Abdomen Peritoneum And Omentum Diagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing (Separate Procedure) |
| 49321-CPT | Moderate | Scope Surgery Of Abdomen, Abdominal Surgery Aided By A Scope (Laparoscopy). This Surgery May Involve Taking Tissue Samples For Testing (Biopsy) Draining A Cyst (Fluid Pocket) Or Implanting A Thin Tube (Catheter) Or Support Device (Stent). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49255. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49255 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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