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 49611 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.
Surgery To Repair Intestine, Surgery To Move The Intestines Back Inside The Abdomen At The Belly Button. The Full Repair Takes More Than One Surgery To Complete.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital |
| Common Modifiers | None GC - Service performed by resident under supervision 58 - Staged or related procedure during postoperative period |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 49611 |
| Medicaid Fee Schedule | View Medicaid rates for 49611 |
National average reimbursement for CPT 49611 by major payers:
$795.27
$810.22
$843.80
$998.82
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 49611.
CPT 49611
5 of 25 sample ratesHigher to lower in this preview
Whitehall Surgery Center, Ltd, Pickerington Surgery Center
$13,332.00Published rateOptimum Surgical Center, LLC, Nascent Paradise Valley Surgical Center
Optimum Surgical Center LLC
$1,146.00Published ratePinehurst Medical Clinic Inc, Pinehurst Medical Clinic Endoscopy Center
Pinehurst Medical Clinic, Inc.
$644.00Published rateHopco Flagstaff Asc Holdings, LLC, Elevation Surgery Center
Hopco Flagstaff Asc Holdings LLC
$463.00Published rateAlta-Rose Surgery Center LLC
$100.00Published 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 49611 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49611 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 49611 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 |
|---|---|---|
| 49600-CPT | Moderate | Surgery To Repair Intestine, Surgery To Move The Intestines Back Inside The Abdomen At The Belly Button. The Full Repair Takes More Than One Surgery To Complete. |
| 49605-CPT | High | Surgery To Repair Intestine, Surgery To Move The Intestines Back Inside The Abdomen At The Belly Button. The Full Repair Takes More Than One Surgery To Complete. |
| 49606-CPT | High | Surgery To Repair Intestine, Surgery To Move The Intestines Back Inside The Abdomen At The Belly Button. The Full Repair Takes More Than One Surgery To Complete. |
| 49611-CPT | Moderate | Surgery To Repair Intestine, Surgery To Move The Intestines Back Inside The Abdomen At The Belly Button. The Full Repair Takes More Than One Surgery To Complete. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49611. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49611 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 49611) and we'll show you how you compare in 15 minutes or less.