CPT 49594 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 • AS - PA/NP/CNS assistant at surgery • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| CMS | $725.86 Physician Fee Schedule |
National average reimbursement for CPT 49594 by major payers:
$946.53
$1,064.47
$1,014.71
$1,269.00
| 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 49594 | ||||||
United | 49594 | $2770.32 | 1699060640 - KAREN ORJUELA TRASLAVINA | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Neurology Physician (2084N0400X) |
United | 49594 | $3228.02 | 1558687624 - RICKA MESSER | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 49594 | $2770.32 | 1275219222 - LANAY ABOGAH | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Acute Care Nurse Practitioner (363LA2100X) |
United | 49594 | $2208.21 | 1053849489 - VERA STALEY | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Physical Medicine & Rehabilitation Physician (208100000X) |
United | 49594 | $2825.71 | 1770503567 - REBECCA PIFER | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Emergency Medicine Physician (207P00000X) |
United | 49594 | $1659.97 | 1316629223 - BRIAN MIKKELSON | 840744042 - (CO) COLORADO SURGICAL SERVICE P.C. | CO | Trauma Surgery Physician (2086S0127X) |
United | 49594 | $2208.21 | 1235800814 - HEATHER FARMER-BAILEY | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Adult Health Nurse Practitioner (363LA2200X) |
United | 49594 | $2825.71 | 1235480567 - ASHLEIGH MAKALA | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Medical Physician Assistant (363AM0700X) |
United | 49594 | $1659.97 | 1154936672 - MARY EIDENT | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | CO | Family Nurse Practitioner (363LF0000X) |
United | 49594 | $2825.71 | 1891167805 - KERI RIECHERS | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Medical Physician Assistant (363AM0700X) |
United | 49594 | $1594.05 | 1154611986 - ANTHONY BACON | 942854057 - IHC HEALTH SERVICES INC | UT | Surgical Critical Care Physician (2086S0102X) |
United | 49594 | $1284.78 | 1932157922 - CHRISTIANNA MARTIN | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | CO | Neonatal Nurse Practitioner (363LN0000X) |
United | 49594 | $2264.42 | 1376905737 - KATIE EGAN | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Plastic and Reconstructive Surgery Physician (2086S0122X) |
United | 49594 | $1706.88 | 1285131292 - MATTHEW WINN | 582030692 - EMORY UNIVERSITY | GA | Surgery Physician (208600000X) |
United | 49594 | $1284.78 | 1831464189 - RENNA BECERRA | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | CO | Internal Medicine Physician (207R00000X) |
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 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 | 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 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.
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.