CPT 49429 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • GC - Service performed by resident under supervision • 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| CMS | $448.00 Physician Fee Schedule |
National average reimbursement for CPT 49429 by major payers:

$555.45

$615.29

$638.53

$750.80
| 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 49429 | ||||||
United | 49429 | $3201.00 | 1669787958 - PINE RIDGE SURGERY CENTER, LLC | 271609169 - (WI) PINE RIDGE SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $2307.00 | 1134183908 - NORTH PALM BEACH COUNTY SURGERY CENTER LLC | 752424900 - (FL) NORTH PALM BEACH COUNTY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $3623.00 | 1447362769 - BETHLEHEM ENDOSCOPY CENTER LLC | 233032591 - (PA) BETHLEHEM ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $2700.00 | 1588312607 - JEWETT ORTHOPEDIC INSTITUTE SURGERY CENTER, LLC | 872667237 - (FL) JEWETT ORTHOPEDIC INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $1088.00 | 1528680865 - MERIDIAN SURGERY CENTER LLC | 845179604 - (MD) MERIDIAN SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $3075.00 | 1225531544 - ANNE ARUNDEL-SCA SURGICENTER, LLC | 824763728 - (MD) ANNE ARUNDELSCA SURGICENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $9418.76 | 1619096161 - THE WESTERN PENNSYLVANIA HOSPITAL, FORBES REGIONAL CAMPUS | 250969492 - (PA) HIGHMARK HEALTH | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $2000.00 | 1003166844 - PSA AMBULATORY SURGERY CENTER OF KILLEEN LLC | 455218356 - (TX) PSA AMBULATORY SURGERY CENTER OF KILLEEN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $1260.00 | 1245346923 - AESTHETIC PLASTIC SURGERY INSTITUTE OF LOUISVILLE, LLC, LOUISVILLE SURGERY CENTER | 611464714 - (KY) AESTHETIC PLASTIC SURGERY INSTITUTE | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $2156.00 | 1093079196 - MERCY HOSPITALS EAST COMMUNITIES, MERCY OUTPATIENTSURGERY CENTER WASHINGTON | 431066883 - (MO) MERCY HOSPITALS EAST COMMUNITIES | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $588.00 | 1356311419 - RIVERSIDE AMBULATORY SURGERY CENTER LLC | 522233625 - (MD) RIVERSIDE AMBULATORY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $2170.00 | 1497843825 - COMMONWEALTH ORTHOPAEDICS & REHABILITATION, PC | 540885859 - (VA) ORTHOVIRGINIA, INC. | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $4339.00 | 1275532889 - COAST SURGERY CENTER L P, COAST SURGERY CENTER OF SOUTH BAY | 450463066 - (CA) COAST SURGERY CENTER L P | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $3570.00 | 1659748184 - SURGCENTER OF THE POTOMAC, LLC | 472311914 - (MD) SURGCENTER OF THE POTOMAC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49429 | $756.00 | 1407131949 - LEE SURGERY CENTER LLC | 453606333 - (OH) LEE SURGERY CENTER LLC | OH | 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 49429 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49429 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 49429 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49429. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49429 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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