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See a sample rate comparisonCPT 49428 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.
Shunt Removal From Abdomen, Procedure To Remove Shunt (Passage That Allows Movement Of Fluid From One Part Of The Body To Another).
| 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 RT - Right side of body 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 49428 |
| Medicaid Fee Schedule | View Medicaid rates for 49428 |
National average reimbursement for CPT 49428 by major payers:
$548.71
$581.72
$596.83
$692.83
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CPT 49428
5 of 25 sample ratesHigher to lower in this preview
Columbia Medical Center Of Plano Subsidiary Lp, Medical City Plano
$2,809.00Published rateArtel LLC
Artel, LLC
$1,000.00Published rateEndoscopy Center Of Dayton North LLC
$767.00Published rateUrology Surgery Center Johns Creek LLC
$700.00Published rateEye Surgery Center Of Michigan LLC
Eye Surgery Center Of Michigan
$500.00Published rate
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See a sample payer proposalCPT 49428 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49428 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 49428 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 |
|---|---|---|
| 49425-CPT | Moderate | Shunt Placement In Abdomen, Procedure To Insert Shunt (Passage That Allows Movement Of Fluid From One Part Of The Body To Another). |
| 49426-CPT | Moderate | Shunt Placement In Abdomen, Procedure To Insert Shunt (Passage That Allows Movement Of Fluid From One Part Of The Body To Another). |
| 49427-CPT | Low | Dye Injection To Examine Shunt, Injection Of Dye For Examination Of A Shunt. The Shunt Enables Fluid To Flow From One Part Of The Body To Another. |
| 49428-CPT | Moderate | Shunt Removal From Abdomen, Procedure To Remove Shunt (Passage That Allows Movement Of Fluid From One Part Of The Body To Another). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49428. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49428 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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