CPT 49325 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 • GC - Service performed by resident under supervision • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
| CMS | $402.71 Physician Fee Schedule |
National average reimbursement for CPT 49325 by major payers:
$507.04
$556.07
$581.74
$688.61
| 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 49325 | ||||||
United | 49325 | $1200.86 | 1053730408 - LISA BAKER | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Neurology Physician (2084N0400X) |
United | 49325 | $1200.86 | 1427316348 - JEREMY HUGH | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Dermatology Physician (207N00000X) |
United | 49325 | $1536.68 | 1871133470 - WREN MAHANNAH | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Certified Registered Nurse Anesthetist (367500000X) |
United | 49325 | $1467.85 | 1528429453 - ANNE TAYLOR | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Interventional Cardiology Physician (207RI0011X) |
United | 49325 | $1506.55 | 1538547583 - MARIA MACHALA | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Acute Care Nurse Practitioner (363LA2100X) |
United | 49325 | $1200.86 | 1053760074 - KELEIGH MCLAUGHLIN | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Anesthesiology Physician (207L00000X) |
United | 49325 | $500.00 | 1124277058 - DIGESTIVE HEALTHCARE OF GEORGIA ENDOSCOPY CENTER MOUNTAINSIDE | 582406657 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49325 | $1091.69 | 1093870552 - PATRICIA HARDENBERGH | 840563230 - (CO) VAIL CLINIC INC | CO | Specialist (174400000X) |
United | 49325 | $871.38 | 1831395433 - KRZYSZTOF WIKIEL | 232919472 - UPMC | CO | Surgery Physician (208600000X) |
United | 49325 | $783.90 | 1699738567 - KYLE NICKEL | 840428757 - (CO) DELTA COUNTY MEMORIAL HOSPITAL | CO | Surgery Physician (208600000X) |
United | 49325 | $484.25 | 1528487451 - CHARLES TRUJILLO | 451154796 | CO | Surgery Physician (208600000X) |
United | 49325 | $510.14 | 1760418198 - ABBAS SYED | 381415390 - (MI) DECKERVILLE COMMUNITY HOSPITAL INC | CO | Surgery Physician (208600000X) |
United | 49325 | $1200.86 | 1124356449 - DANA STALILIONIS | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | IL | Certified Registered Nurse Anesthetist (367500000X) |
United | 49325 | $724.89 | 1417375320 - SANY THOMAS | 841343242 | CO | Surgery Physician (208600000X) |
United | 49325 | $3268.00 | 1689699597 - NAPA SURGERY CENTER LLC | 680366295 - (CA) NAPA SURGERY CENTER LLC | CA | 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 49325 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49325 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 49325 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 |
|---|---|---|
| 49013-CPT | Moderate | Preperitoneal Pelvic Packing For Hemorrhage Associated With Pelvic Trauma Including Local Exploration |
| 49014-CPT | Moderate | Re-Exploration Of Pelvic Wound With Removal Of Preperitoneal Pelvic Packing Including Repacking When Performed |
| 49323-CPT | Moderate | Laparoscopy, Surgical; W Drainage Of Lymphocele To Peritoneal Cavity |
| 49325-CPT | Moderate | Laparoscopy, Surgical; With Revision Of Previously Placed Intraperitoneal Cannula Or Catheter, With Removal Of Intraluminal Obstructive Material If Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49325. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49325 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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