CPT 49450 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 • AG - Primary physician • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| CMS | $548.60 Physician Fee Schedule |
National average reimbursement for CPT 49450 by major payers:
$699.57
$905.12
$936.74
$995.61
| 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 49450 | ||||||
United | 49450 | $1154.56 | 1659668804 - RAGHAV GUPTA | 350593390 - DEACONESS HOSPITAL INC | IN | Pulmonary Disease Physician (207RP1001X) |
United | 49450 | $1160.46 | 1801813266 - GREGG BEAN | 741671142 - (TX) SOUTH TEXAS RADIOLOGY GROUP, P.A. | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 49450 | $1154.56 | 1942683263 - JAMES ALSOP | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 49450 | $530.47 | 1356009468 - MELISSA MCKINNEY | 350593390 - DEACONESS HOSPITAL INC | KY | Certified Registered Nurse Anesthetist (367500000X) |
United | 49450 | $1154.56 | 1629607510 - KAREEM EL-KHODARY | 350593390 - DEACONESS HOSPITAL INC | IN | Internal Medicine Physician (207R00000X) |
United | 49450 | $1154.56 | 1609154483 - TRESA NESBITT | 350593390 - DEACONESS HOSPITAL INC | GA | Hospitalist Physician (208M00000X) |
United | 49450 | $1154.56 | 1225328271 - ALEXIS HUYNH | 350593390 - DEACONESS HOSPITAL INC | NY | Hospitalist Physician (208M00000X) |
United | 49450 | $1154.56 | 1982086161 - ADETOLA OTESILE | 350593390 - DEACONESS HOSPITAL INC | KY | Hospitalist Physician (208M00000X) |
United | 49450 | $530.47 | 1306395439 - VIRGINIA LATOUCHE | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 49450 | $1154.56 | 1619553682 - FREDERIC KARIM | 350593390 - DEACONESS HOSPITAL INC | NY | Hospitalist Physician (208M00000X) |
United | 49450 | $530.47 | 1265160881 - LISA KOOP | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 49450 | $530.47 | 1770868606 - EMILY MURPHY | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 49450 | $1154.56 | 1255530317 - APRIL TOELLE | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 49450 | $1154.56 | 1679586705 - NAVEEN DEVABHAKTUNI | 350593390 - DEACONESS HOSPITAL INC | IN | Cardiovascular Disease Physician (207RC0000X) |
United | 49450 | $1933.07 | 1487657698 - ROBERT BELKIN | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Cardiovascular Disease Physician (207RC0000X) |
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 49450 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49450 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 49450 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 |
|---|---|---|
| 49441-CPT | High | Insertion Of Duodenostomy Or Jejunostomy Tube, Percutaneous, Under Fluoroscopic Guidance Including Contrast Injection(S), Image Documentation And Report |
| 49442-CPT | High | Insertion Of Cecostomy Or Other Colonic Tube, Percutaneous, Under Fluoroscopic Guidance Including Contrast Injection(S), Image Documentation And Report |
| 49446-CPT | Moderate | Conversion Of Gastrostomy Tube To Gastro- Jejunostomy Tube Percutaneous Under Fluorscopic Guidance Including Contract Injection(S) Image Documentation & Report |
| 49450-CPT | Moderate | Replacement Of Gastrostomy Or Cecostomy (Or Other Colonic) Tube Percutaneous Under Fluoroscopic Guidance Including Contrast Injection(S) Image Documentation And Report |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49450. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49450 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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