CPT 49592 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 • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| CMS | $463.85 Physician Fee Schedule |
National average reimbursement for CPT 49592 by major payers:
$606.61
$678.87
$650.31
$813.89
| 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 49592 | ||||||
United | 49592 | $1053.63 | 1013905926 - ELIZABETH BISGARD | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | CO | Occupational Medicine Physician (2083X0100X) |
United | 49592 | $18000.00 | 1427585280 - PINNACLE SURGERY CENTER, INC | 812354493 - (CA) PINNACLE SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49592 | $1766.78 | 1184883340 - EMILY MALGOR | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Vascular Surgery Physician (2086S0129X) |
United | 49592 | $1802.11 | 1861952491 - NATHAN RIETBERG | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Anesthesiology Physician (207L00000X) |
United | 49592 | $1444.15 | 1740626530 - JESSICA SAADE | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Primary Care Nurse Practitioner (363LP2300X) |
United | 49592 | $1952.00 | 1003889346 - ENDOSCOPY GROUP LLC | 593519881 - (FL) ENDOSCOPY GROUP, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49592 | $733.27 | 1760554521 - MARCIA MOORE | 430633449 - MISSOURI DELTA MEDICAL CENTER | CO | Surgery Physician (208600000X) |
United | 49592 | $1408.30 | 1417406935 - NINA ROBINSON | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Nurse Practitioner (363LP0200X) |
United | 49592 | $1408.30 | 1144549544 - JOEL KNIEP | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Anatomic Pathology & Clinical Pathology Physician (207ZP0102X) |
United | 49592 | $1766.78 | 1053328864 - JULIA KIMBALL | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Optometrist (152W00000X) |
United | 49592 | $1459.60 | 1801380613 - AUSTIN MOMII | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Neurology Physician (2084N0400X) |
United | 49592 | $1648.98 | 1184629602 - HAL JOSEPH | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Medical Physician Assistant (363AM0700X) |
United | 49592 | $2058.67 | 1053408104 - BRIAN PERRY | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Medical Physician Assistant (363AM0700X) |
United | 49592 | $7968.00 | 1417534207 - MEDICAL CITY SURGERY CENTER OF FRISCO, LLC | 822432064 - (TX) MEDICAL CITY SURGERY CENTER OF FRISCO LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49592 | $1802.11 | 1619102746 - KERRI THURMON | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | KS | Urology Physician (208800000X) |
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 49592 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49592 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 49592 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 |
|---|---|---|
| 49591-CPT | Moderate | Repair Of Anterior Abdominal Hernia(S) (Ie, Epigastric, Incisional, Ventral, Umbilical, Spigelian), Any Approach (Ie, Open, Laparoscopic, Robotic), Initial, Including Implantation Of Mesh Or Other Prosthesis When Performed, Total Length Of Defect(S); Less Than 3 Cm, Reducible |
| 49592-CPT | Moderate | Repair Of Anterior Abdominal Hernia(S) (Ie, Epigastric, Incisional, Ventral, Umbilical, Spigelian), Any Approach (Ie, Open, Laparoscopic, Robotic), Initial, Including Implantation Of Mesh Or Other Prosthesis When Performed, Total Length Of Defect(S); Less Than 3 Cm, Incarcerated Or Strangulated |
| 49593-CPT | Moderate | Repair Of Anterior Abdominal Hernia(S) (Ie, Epigastric, Incisional, Ventral, Umbilical, Spigelian), Any Approach (Ie, Open, Laparoscopic, Robotic), Initial, Including Implantation Of Mesh Or Other Prosthesis When Performed, Total Length Of Defect(S); 3 Cm To 10 Cm, Reducible |
| 49594-CPT | Moderate | Repair Of Anterior Abdominal Hernia(S) (Ie, Epigastric, Incisional, Ventral, Umbilical, Spigelian), Any Approach (Ie, Open, Laparoscopic, Robotic), Initial, Including Implantation Of Mesh Or Other Prosthesis When Performed, Total Length Of Defect(S); 3 Cm To 10 Cm, Incarcerated Or Strangulated |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49592. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49592 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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