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See a sample rate comparisonCPT 49321 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.
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).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 49321 |
| Medicaid Fee Schedule | View Medicaid rates for 49321 |
National average reimbursement for CPT 49321 by major payers:
$437.09
$463.09
$513.68
$560.07
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CPT 49321
5 of 25 sample ratesHigher to lower in this preview
Thousand Oaks Surgery Center, LLC
Thousand Oaks Surgery Center LLC
$15,000.00Published rateDoctors Outpatient Surgery Center Of Jupiter, LLC, Laser & Surgery Center Of The Palm Beaches
Drs. Outpatient Surgery Center Of Jupiter, LLC
$5,354.00Published rateHeart Health Center, LLC
Heart Health Center LLC
$2,400.00Published rateMemphis Eye And Cataract Ambulatory Surgery Center Inc, Meca Laser And Surgery Center
Memphis Eye And Cataract Ambulatory Surgery Center Inc
$1,540.00Published rateWest Clinic Astc, West Clinic, PC
The West Clinic, PLLC
$905.00Published rate
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See a sample payer proposalCPT 49321 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49321 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 49321 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 |
|---|---|---|
| 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). |
| 49322-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). |
| 49323-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 49321. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49321 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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