CPT 49465 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 • 23 - Emergency Room |
| Common Modifiers | • None • GC - Service performed by resident under supervision • AG - Primary physician |
| Complexity Level | Low |
| CMS | $129.39 Physician Fee Schedule |
National average reimbursement for CPT 49465 by major payers:
$169.18
$211.44
$216.10
$243.37
| 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 49465 | ||||||
United | 49465 | $276.04 | 1841570140 - PRASONGCHAI SATTAYAPRASERT | 350593390 - DEACONESS HOSPITAL INC | IN | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | 49465 | $225.28 | 1801813266 - GREGG BEAN | 741586031 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 49465 | $276.04 | 1760809198 - AVI ARORA | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 49465 | $126.83 | 1316496557 - ALYSSA GLENN | 350593390 - DEACONESS HOSPITAL INC | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 49465 | $126.83 | 1316708365 - BRENT BLAND | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 49465 | $276.04 | 1336395565 - KAMAL ABULEBDA | 350593390 - DEACONESS HOSPITAL INC | IN | Pediatric Critical Care Medicine Physician (2080P0203X) |
United | 49465 | $276.04 | 1235391491 - JAMIE DAVISON | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 49465 | $276.04 | 1639432107 - BABATUNDE OYEDIRAN | 350593390 - DEACONESS HOSPITAL INC | TX | Anesthesiology Physician (207L00000X) |
United | 49465 | $276.04 | 1144462797 - COLBY DORROH | 350593390 - DEACONESS HOSPITAL INC | KY | Emergency Medicine Physician (207P00000X) |
United | 49465 | $126.83 | 1114766979 - TYLER UNFRIED | 350593390 - DEACONESS HOSPITAL INC | KY | Physician Assistant (363A00000X) |
United | 49465 | $276.04 | 1972593572 - ANDREW PARKER | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
United | 49465 | $276.04 | 1568425692 - CHANDRASHEKAR KUMBAR | 350593390 - DEACONESS HOSPITAL INC | IN | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | 49465 | $276.04 | 1720435118 - ELIZABETH TURLEY | 350593390 - DEACONESS HOSPITAL INC | KY | Family Medicine Physician (207Q00000X) |
United | 49465 | $126.83 | 1689171589 - SARA FERGUS | 350593390 - DEACONESS HOSPITAL INC | IN | Family Nurse Practitioner (363LF0000X) |
United | 49465 | $276.04 | 1497069926 - ELVIRA CANE | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 49465 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49465 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 49465 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 |
| 49450-CPT | Moderate | Replacement Of Gastrostomy Or Cecostomy (Or Other Colonic) Tube Percutaneous Under Fluoroscopic Guidance Including Contrast Injection(S) Image Documentation And Report |
| 49465-CPT | Low | Contract Injection(S) For Radiological Eval Uation Of Existing Gastrostomy Duodenostomy Jejuonstomy Gastro-Jejunostomy Or Cecostomy (Or Other Colonic) Tube From A Percutaneous Approach Including 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 49465. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49465 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 49465) and we'll show you how you compare in 15 minutes or less.