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See a sample rate comparisonCPT 49436 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.
Delayed Creation Of Exit Site, Delayed Creation Of Exit Site From Embedded Subcutaneous Segment Of Intraperitoneal Cannula Or Catheter
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None AG - Primary physician 58 - Staged or related procedure during postoperative period |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 49436 |
| Medicaid Fee Schedule | View Medicaid rates for 49436 |
National average reimbursement for CPT 49436 by major payers:
$373.62
$271.90
$386.59
$323.99
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CPT 49436
5 of 25 sample ratesHigher to lower in this preview
Ku Medwest Ambulatory Surgery Center, LLC
Ku Medwest Ambulatory Surgery Center LLC
$3,563.00Published rateSky Ridge Surgery Center Lp
$1,558.00Published rateHouston Surgery Center
Houston Surgery Center Lp
$981.00Published rateTidalhealth Surgery Center, LLC
$614.00Published rateFt Myers Digestive Health And Pain Asc LLC, Center For Digestive Health And Pain Management
Ft Myers Digestive Health And Pain Asc LLC
$404.00Published rate
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See a sample payer proposalCPT 49436 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49436 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 49436 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). |
| 49435-CPT | Low | Insertion Of Subcutaneous Exte, Insertion Of Subcutaneous Extension To Intraperitoneal Cannula Or Catheter With Remote Chest Exit Site (List Separately In Addition To Code For Primary Procedure) |
| 49436-CPT | Moderate | Delayed Creation Of Exit Site, Delayed Creation Of Exit Site From Embedded Subcutaneous Segment Of Intraperitoneal Cannula Or Catheter |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49436. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49436 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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