CPT 49322 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| CMS | $367.13 Physician Fee Schedule |
National average reimbursement for CPT 49322 by major payers:
$457.51
$500.23
$553.86
$619.55
| 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 49322 | ||||||
United | 49322 | $4757.00 | 1659443042 - HALLANDALE OUTPATIENT SURGICAL CENTER,LTD | 200244303 - (FL) HALLANDALE OUTPATIENT SURGICAL CENTERLTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $3624.00 | 1730227992 - MEMORIAL AMBULATORY SURGERY CENTER, LLC | 210634562 - (NJ) VIRTUA-MEMORIAL HOSPITAL BURLINGTON COUNTY INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $2950.00 | 1649501073 - SHORE HEALTH SYSTEM, INC., SHORE HEALTH SYSTEM SURGERY CENTER | 520610538 - (MD) SHORE HEALTH SYSTEM INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $11927.00 | 1053361642 - DEACONESS HOSPITAL, INC. | 350593390 - DEACONESS HOSPITAL INC | IN | General Acute Care Hospital (282N00000X) |
United | 49322 | $5354.00 | 1174778047 - RSC ILLINOIS LLC, REGIONAL SURGICENTER | 261363389 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $750.00 | 1649407180 - PAIN MDS INC | 270279190 - (AZ) PAIN MDS INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $5433.00 | 1659748184 - SURGCENTER OF THE POTOMAC, LLC | 472311914 - (MD) SURGCENTER OF THE POTOMAC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $3500.00 | 1033560420 - ABINGDON SURGICAL CENTER PC | 813054896 - (MD) ABINGDON SURGICAL CENTER PC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $3100.00 | 1588092605 - GOLD COAST SURGERY CENTER, CENTER FOR SPECIALIZED SURGERY OF SANTA BARBARA | 460639888 - GOLD COAST SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $2000.00 | 1649443367 - SKIN SURGERY CENTER OF VIRGINIA | 262319829 - (VA) SKIN SURGERY CENTER OF VIRGINIA | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $5354.00 | 1891298089 - MICHIGAN OUTPATIENT SURGICAL SOLUTIONS, LLC | 821706937 - (MI) MICHIGAN OUTPATIENT SURGICAL SOLUTIONS LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $1816.00 | 1790710390 - SOUTHWESTERN MEDICAL CENTER, LLC, MAGNA SURGICAL CENTER | 364212258 - (IL) SOUTHWESTERN MEDICAL CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $4234.00 | 1760912554 - BAYLOR SURGICARE AT BAYLOR PLANO, LLC, BAYLOR SCOTT & WHITE SURGICARE AT PLANO ALLIANCE | 813127185 - (TX) BAYLOR SURGICARE AT BAYLOR PLANO LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $5200.00 | 1033714001 - SURGERY CENTER AT SOUTH OGDEN, LLC | 854070407 - (UT) SURGERY CENTER AT SOUTH OGDEN LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $5020.00 | 1942715826 - SAFETY HARBOR ASC COMPANY LLC, SAFETY HARBOR SURGERY CENTER | 320547161 | FL | 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 49322 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49322 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 49322 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, Abdomen, Peritoneum, And Omentum, Diagnostic, With Or Without Collection Of Specimen(S) By Brushing Or Washing (Separate Procedure) |
| 49321-CPT | Moderate | Laparoscopy, Surgical, Abdomen; With Biopsy (Single Or Multiple) |
| 49322-CPT | Moderate | Laparoscopy, Surgical; With Aspiration Of Cavity/Cyst (Eg, Ovarian Cyst) (Single/Multiple) |
| 49323-CPT | Moderate | Laparoscopy, Surgical; W Drainage Of Lymphocele To Peritoneal Cavity |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49322. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49322 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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