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See a sample rate comparisonCPT 49623 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.
Rmvl Ninfct Mesh Hernia Rpr, 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
| 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 AS - PA/NP/CNS assistant at surgery 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 49623 |
| Medicaid Fee Schedule | View Medicaid rates for 49623 |
National average reimbursement for CPT 49623 by major payers:
$255.96
$281.48
$270.21
$335.34
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CPT 49623
5 of 25 sample ratesHigher to lower in this preview
Saint Lukes South Pain Management Center LLC
$5,213.00Published rateEastland Medical Plaza Surgicenter, LLC
Eastland Medical Plaza Surgicenter LLC
$567.00Published rateValley Surgery Center LLC
$308.00Published rateSummit Surgery Center Modesto, Inc
Summit Surgery Center Modesto Inc
$117.00Published ratePrince Georges Multi Specialty Surgery Center
$39.00Published rate
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See a sample payer proposalCPT 49623 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49623 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 49623 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 | Rpr Parastomal Hernia Rdc, 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 | Rpr Parastomal Hrna Ncr Strn, 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 | Rmvl Ninfct Mesh Hernia Rpr, 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 49623. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49623 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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