CPT 49622 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | High |
| CMS | $910.88 Physician Fee Schedule |
National average reimbursement for CPT 49622 by major payers:
$1,223.35
$1,305.66
$1,240.78
$1,560.46
| 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 49622 | ||||||
United | 49622 | $1500.00 | 1396141545 - AXIS SURGERY CENTER LLC | 463623155 - (GA) AXIS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $20777.00 | 1295887727 - TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS | 751047527 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $2038.00 | 1164646071 - ATLANTIC PLASTIC SURGERY ASSOCIATES PA | 20401481 - (NH) ATLANTIC PLASTIC SURGERY ASSOCIATES, P.A. | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $4704.00 | 1073694550 - ROCKWALL AMBULATORY SURGERY CENTER LLP, BAYLOR SCOTT & WHITE SURGICARE - ROCKWALL | 205506447 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $3199.00 | 1306503057 - PAIN CARE SURGERY OF LOUISVILLE, LLC | 844317137 - (KY) PAIN CARE SURGERY OF LOUISVILLE LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $5981.00 | 1922255413 - TWIN CITIES AMBULATORY SURGERY CENTER LP, TWIN CITIES SURGERY CENTER | 260839397 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $1800.00 | 1801855127 - CENTER FOR THE SURGICAL ARTS LLC, CSA | 113741353 - (PA) CENTER FOR THE SURGICAL ARTS LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $4500.00 | 1144265539 - THE MIDLAND SURGICAL CENTER LLC | 352194610 - (IL) THE MIDLAND SURGICAL CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $3275.00 | 1457674236 - CORM SURGICENTER | 260681153 - (TX) CORM SURGICENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $1339.00 | 1528039567 - PREMIER PROFESSIONAL SURGERY CENTER PC, PARKEYE SURGI CENTER | 381894684 - (MI) PARK EYE & SURGI CENTER | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $10126.00 | 1750892659 - NOVANT HEALTH KERNERSVILLE OUTPATIENT SURGERY LLC | 821651821 - (NC) NOVANT HEALTH KERNERSVILLE OUTPATIENT SURGERY LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $3489.00 | 1538124490 - CITRUS REGIONAL SURGERY CENTER LP | 621510209 - (FL) CITRUS REGIONAL SURGERY CENTER LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $3000.00 | 1942637301 - MICHIANA SURGERY CENTER, LLC | 461007801 - (IN) MICHIANA SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $1800.00 | 1023123296 - ASSOCIATES SURGERY CENTERS, LLC | 510492139 - (PA) ASSOCIATES SURGERY CENTERS LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 49622 | $2369.00 | 1326136177 - TEANECK GASTROENTEROLOGY&ENDOSCOPY CENTER | 223348806 - (NJ) TEANECK GASTROENTEROLOGYENDOSCOPY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 49622 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49622 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 49622 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 |
|---|---|---|
| 49621-CPT | Moderate | Repair Of Parastomal Hernia, Any Approach (Ie, Open, Laparoscopic, Robotic), Initial Or Recurrent, Including Implantation Of Mesh Or Other Prosthesis, When Performed; Reducible |
| 49622-CPT | High | Repair Of Parastomal Hernia, Any Approach (Ie, Open, Laparoscopic, Robotic), Initial Or Recurrent, Including Implantation Of Mesh Or Other Prosthesis, When Performed; Incarcerated Or Strangulated |
| 49623-CPT | Moderate | Removal Of Total Or Near Total Non-Infected Mesh Or Other Prosthesis At The Time Of Initial Or Recurrent Anterior Abdominal Hernia Repair Or Parastomal Hernia Repair, Any Approach (Ie, Open, Laparoscopic, Robotic) (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49622. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49622 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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