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 |
| Medicare Fee Schedule | View Medicare rates for 49322 |
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 | $1919.00 | 1730570003 - SMART PAIN SURGERY CENTER AT GERMANTOWN, LLC, CLEARWAY SURGERY CENTER OF GERMANTOWN | 472908671 - (MD) SMART PAIN SURGERY CENTER AT GERMANTOWN LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $5249.00 | 1811515034 - SALMON SURGERY CENTER LLC | 844895716 - (WA) SALMON SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $656.00 | 1144326307 - OLD MOULTRIE SURGICAL CENTER INC | 593572609 - (FL) OLD MOULTRIE SURGICAL CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $644.84 | 1285927277 - FAISAL TAWWAB | 350593390 - DEACONESS HOSPITAL INC | FL | Hospitalist Physician (208M00000X) |
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 | $2266.00 | 1336209451 - SADDLE RIVER VALLEY SURGICAL CENTER LLC, SADDLE RIVER VALLEY SURGICAL CENTER LLC | 201250583 - (NJ) SADDLE RIVER VALLEY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $2999.00 | 1235677808 - ATHENS ORTHOPEDIC CLINIC AMBULATORY SURGERY CENTER-LOGANVILLE, LLC | 812389963 | GA | 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 | $2600.00 | 1649463605 - PRINCETON ORTHOPAEDIC ASSOCIATES II PA | 223471829 - (NJ) PRINCETON ORTHOPAEDIC ASSOCIATES II, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $3150.00 | 1992259337 - ADVOCATE CONDELL AMBULATORY SURGERY CENTER, LLC | 475337115 - (IL) ADVOCATE CONDELL AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $1088.00 | 1386823854 - THE GLENDALE AZ ENDOSCOPY ASC LLC, THUNDERBIRD ENDOSCOPY CENTER | 260506545 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $3155.00 | 1609825298 - SURGERY CENTER OF IDAHO LLC | 204831740 - (ID) SURGERY CENTER OF IDAHO LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $3486.00 | 1669176020 - MEDSTAR SURGERY CENTER 1, LLC | 922094391 - (MD) MEDSTAR SURGERY CENTER 1 LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $4757.00 | 1659443042 - HALLANDALE OUTPATIENT SURGICAL CENTER,LTD | 200244303 - (FL) HALLANDALE OUTPATIENT SURGICAL CENTERLTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49322 | $2412.00 | 1912252693 - ROCKWOOD CLINIC PS, ROCKWOOD EYE SURGERY CENTER | 911352172 - MULTICARE HEALTH SYSTEM | WA | 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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