CPT 49411 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 • 11 - Office |
| Common Modifiers | • None • 51 - Multiple procedures • AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 49411 |
National average reimbursement for CPT 49411 by major payers:
$588.64
$673.19
$705.36
$803.83
| 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 49411 | ||||||
United | 49411 | $680.00 | 1861702359 - INLAND OUTPATIENT SURGERY CENTER, INC. | 900621582 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49411 | $3994.00 | 1891935201 - EAST CAMPUS SURGERY CENTER LLC | 352028517 - (IN) EAST CAMPUS SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49411 | $548.00 | 1649921065 - JOINT REPLACEMENT CENTER OF LOUISIANA | 874022126 - (LA) JOINT REPLACEMENT CENTER OF LOUS | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49411 | $1369.00 | 1033635206 - MEDSTAR SURGERY CENTER AT TIMONIUM, LLC | 821874292 - (MD) MEDSTAR SURGERY CENTER AT TIMO | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49411 | $700.00 | 1932132065 - AMBULATORY SURGICAL CTR OF AIKEN LLC, THE SURGERY CENTER OF AIKEN | 830879278 | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49411 | $448.17 | 1205859550 - COMMUNITY SURGERY & LASER CENTER, LLC | 204589384 - (PA) COMMUNITY SURGERY LASER CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49411 | $1179.00 | 1235146325 - WEBSTER AMBULATORY SURGERY CENTER LP, WEBSTER SURGERY CENTER | 205953387 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49411 | $475.00 | 1154412757 - SURGICENTER LTD, BLOOMBERG EYE CENTER | 311585329 - (OH) SURGICENTER LTD | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49411 | $644.00 | 1336635747 - ROCKVILLE SURGICAL SUITES, LLC | 825263227 - (MD) ROCKVILLE SURGICAL SUITES LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49411 | $930.00 | 1225781891 - SURGERY NEVADA LLC | 874665425 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49411 | $850.60 | 1386664852 - HIRAK SEN | 350593390 - DEACONESS HOSPITAL INC | FL | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | 49411 | $517.00 | 1821279720 - NEW ORLEANS LA UPTOWN WEST BANK ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND THERAPEUTIC CENTER | 205904604 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49411 | $1123.00 | 1114302353 - POINT OF ROCKS SURGERY CENTER, LLC | 464992977 - (MD) POINT OF ROCKS SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49411 | $461.00 | 1245215706 - SOUTHSIDE FOOT CLINIC OF SHREVEPORT INC A PROFESSIONAL CORPORATION, THE FOOT SURGERY CENTER OF SHREVEPORT | 721198169 - (LA) SOUTHSIDE FOOT CLINIC OF SHREVEPORT INC A PROFESSIONAL CORPORATION | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49411 | $669.00 | 1093121196 - GULF COAST OUTPATIENT SURGERY CENTER, LLC | 640935301 - (MS) GULF COAST OUTPATIENT SURGERY CENTER, LLC | MS | 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 49411 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49411 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 49411 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 |
|---|---|---|
| 49327-CPT | Low | Laparoscopy Surgical; With Placement Of Intersitial Device(S) For Radiation Therapy Guidance (Eg Fiducial Markers Dosimeter) Intra-Abdominal Intrapelvic And/Or Retroperitoneum Including Imaging Guidance If Performed Single Or Multiple (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 |
| 49407-CPT | Moderate | Image-Guided Fluid Collection Drainage By Catheter (Eg, Abscess, Hematoma, Seroma, Lymphocele, Cyst); Peritoneal Or Retroperitoneal, Transvaginal Or Transrectal |
| 49411-CPT | Moderate | Placement Of Interstitial Device(S) For Radiation Therapy Guidance (Eg, Fiducial Markers, Dosimeter), Percutaneous, Intra-Abdominal, Intra-Pelvic (Except Prostate), And/Or Retroperitoneum, Single Or Multiple |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49411. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49411 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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