CPT 49326 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 • AS - PA/NP/CNS assistant at surgery • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| CMS | $181.46 Physician Fee Schedule |
National average reimbursement for CPT 49326 by major payers:
$226.41
$253.60
$259.08
$313.47
| 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 49326 | ||||||
United | 49326 | $140.00 | 1508528910 - CHEROKEE FARM ORTHOPEDIC SURGERY CENTER, LLC | 850654744 - (TN) CHEROKEE FARM ORTHOPEDIC SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $93.00 | 1508839473 - NEWARK ENDOSCOPY ASC LLC, ENDOSCOPY CENTER OF DELAWARE | 621867825 - (DE) NEWARK ENDOSCOPY ASC LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $150.00 | 1104858513 - DOCTORS OUTPATIENT SURGERY CENTER LLC, SURGERY CENTER | 721341061 - (LA) DOCTORS OUTPATIENT SURGERY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $389.00 | 1639195217 - CY FAIR SURGERY CENTER | 760386971 - (TX) CY FAIR SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $692.00 | 1720001928 - CAMPBELL CLINIC SURGERY CENTER, LLC | 621826300 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $788.00 | 1093595696 - NEW LEXINGTON CLINIC PSC, DERMATOLOGY ASSOCIATES OF KENTUCKY PSC | 611262927 - (KY) NEW LEXINGTON CLINIC, P.S.C. | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $203.00 | 1306989249 - MEDICAL ARTS SURGERY CENTER LLC | 208261564 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $121.00 | 1669586376 - JEFFERSON AMBULATORY SURGERY CENTER LLC | 202349222 - (LA) JEFFERSON AMBULATORY SURGERY C | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $244.00 | 1295897106 - WESTMONT SURGERY CENTER LLC, SALT CREEK SURGERY CENTER | 364419691 - WESTMONT SURGERY CENTER, LLC DBA SALT CREEK SURGERY CENTER | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $261.00 | 1063531911 - NJ VEIN & COSMETIC SURGERY CENTER, PA | 223328362 - (NJ) NJ VEIN COSMETIC SURGERY CENTER PA | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $258.00 | 1639164916 - THE SURGERY CENTER AT SACRED HEART MEDICAL PARK, DESTIN, LLC | 562315052 - (FL) THE SURGERY CENTER AT SACRED HEART MEDICAL PARK DESTIN LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $120.00 | 1669869111 - LB SURGICAL CENTER LLC | 473797318 - (CA) LB SURGICAL CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $566.00 | 1215091087 - CORPUS CHRISTI SURGICARE LTD, CHRISTUS SPOHN TEXAS ORTHOPEDIC CENTER OF EXCELLENCE | 753049514 - (TX) CORPUS CHRISTI SURGICARE LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $160.00 | 1710081443 - VENTURA ENDOSCOPY CENTER LLC | 680543503 - (CA) VENTURA ENDOSCOPY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49326 | $67.00 | 1386820694 - URO-CENTER AMBULATORY SURGICAL CENTER LLC | 522267795 - (MD) UROCENTER AMBULATORY SURGICAL CENTER LLC | MD | 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 49326 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49326 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 49326 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 |
|---|---|---|
| 49000-CPT | Moderate | Laparotomy/Celiotomy Exploratory |
| 49255-CPT | Moderate | Omentectomy/Epiploectomy |
| 49326-CPT | Moderate | Laparoscopy, Surgical; With Omentopexy (Omental Tacking Procedure) (List Separately In Addition To Code For Primary Procedure) |
| 49406-CPT | Moderate | Image-Guided Fluid Collection Drainage By Catheter (E.G., Abscess, Hematoma, Seroma, Lymphocele, Cyst); Peritoneal Or Retroperitoneal, Percutaneous |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49326. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49326 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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