CPT 49593 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 |
| Medicare Fee Schedule | View Medicare rates for 49593 |
National average reimbursement for CPT 49593 by major payers:
$735.36
$817.62
$786.74
$978.17
| 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 49593 | ||||||
United | 49593 | $521.21 | 1598002214 - JORDAN COUCHON | 841288940 - (CO) PHYSICAL THERAPY INDUSTRIAL SERVICES PC | CO | Specialist (174400000X) |
United | 49593 | $1455.00 | 1952648966 - WENATCHEE VALLEY HOSPITAL, CONFLUENCE HEALTH OMAK ASC | 455563741 - WENATCHEE VALLEY HOSPITAL | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49593 | $1739.29 | 1720533698 - CATHERINE BOUTS | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Physician Assistant (363A00000X) |
United | 49593 | $1492.23 | 1568646362 - JASON PFLUKE | 823370086 | CO | Surgery Physician (208600000X) |
United | 49593 | $2035.33 | 1356809743 - KARI FONTENOT | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Adult Health Nurse Practitioner (363LA2200X) |
United | 49593 | $968.33 | 1336972447 - MOLLY MORRIS | 10803945 - (CO) MOUNTAIN VIEW SURGICAL ASSOCIATES | CO | Family Nurse Practitioner (363LF0000X) |
United | 49593 | $2516.52 | 1407020951 - THERESA CHIN | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | Surgery Physician (208600000X) |
United | 49593 | $2249.00 | 1851317614 - KENDALL POINTE SURGERY CENTER LLC | 364236445 - (IL) KENDALL POINTE SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49593 | $2170.40 | 1821410101 - DENISE QUATTLEBAUM | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Surgical Physician Assistant (363AS0400X) |
United | 49593 | $2127.86 | 1750549242 - PATRICK KNEELAND | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Hospitalist Physician (208M00000X) |
United | 49593 | $986.83 | 1962407528 - DAVID LUEDKE | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | CO | Certified Registered Nurse Anesthetist (367500000X) |
United | 49593 | $1739.29 | 1982117115 - MARCY HOATH | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | VA | Physician Assistant (363A00000X) |
United | 49593 | $1280.84 | 1942400148 - KRISTIN LAPORTE | 840405257 - CATHOLIC HEALTH INITIATIVES COLORADO | CO | Specialist (174400000X) |
United | 49593 | $2479.41 | 1598046450 - JULIA HOLTMANN | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 49593 | $2529.00 | 1124605233 - CATHERINE RODRIGUEZ | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | 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 |
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CPT 49593 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49593 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 49593 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 49593. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49593 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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