Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 49594 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.
Rpr Aa Hrn 1st 3 10 Ncr Strn, 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
| 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 AS - PA/NP/CNS assistant at surgery 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 49594 |
| Medicaid Fee Schedule | View Medicaid rates for 49594 |
National average reimbursement for CPT 49594 by major payers:
$946.53
$1,064.47
$1,014.71
$1,224.69
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 49594.
CPT 49594
5 of 25 sample ratesHigher to lower in this preview
Chris Schettino
University Physicians Incorporated
$3,292.58Published rateAshleigh Makala
University Physicians Incorporated
$2,825.71Published rateRussell Whelan
University Physicians Incorporated
$2,649.87Published rateOrthopedic Surgery Center LLC, Orthopedic Surgery Center
Orthopedic Surgery Center, LLC.
$2,111.00Published rateDoru Georgescu
Center Of Surgical Specialists PC
$934.50Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 49594 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49594 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 49594 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 | Rpr Aa Hrn 1st 3 Cm Rdc, 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 | Rpr Aa Hrn 1st 3 Ncr Strn, 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 | Rpr Aa Hrn 1st 3 10 Rdc, 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 | Rpr Aa Hrn 1st 3 10 Ncr Strn, 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 49594. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49594 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 49594) and we'll show you how you compare in 15 minutes or less.