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See a sample rate comparisonCPT 49323 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 | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service 78 - Return to OR - related procedure 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 49323 |
| Medicaid Fee Schedule | View Medicaid rates for 49323 |
National average reimbursement for CPT 49323 by major payers:
$819.47
$852.60
$871.46
$1,024.54
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CPT 49323
5 of 25 sample ratesHigher to lower in this preview
Texas Health Surgery Center Southwest Fort Worth, LLC
Texas Health Surgery Center Southwest Fort Worth LLC
$8,238.00Published rateEast West Surgery Center Lp
$5,433.00Published rateSouthern Hills Surgery Center Lp, Southern Hills Surgery Center
$3,457.00Published rateVolusia Asc Bz, LLC, Advanced Heart And Vascular Surgery Center At Deltona
Volusia Asc Bz, LLC
$2,529.00Published rateWarren Gastro Endoscopy Ctr Inc
$926.00Published rate
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See a sample payer proposalCPT 49323 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49323 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 49323 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 |
|---|---|---|
| 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). |
| 49324-CPT | Moderate | Surgery To Embed Catheter, Surgery To Embed A Thin Tube (Catheter) Into The Tissues Or Under The Skin. The Catheter May Have A Sealable Opening (Port). Typically An Embedded Catheter Is Used For Dialysis Or To Deliver Medicines. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49323. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49323 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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