CPT 49190 Surgery - Digestive

How Much Does Opn Excision/dstr Ntra-abdominal >30 Cm Cost?

Also known as: Opn exc/dstr ntra-abd >30 cm (CPT 49190)

Opn Excision/dstr Ntra-abdominal >30 Cm (CPT 49190) costs $2,640 at Medicare rates.

Medicare (Facility)
$2,640
CMS PFS 2026 national rate

Procedures Commonly Done Together

These procedures are frequently performed alongside Opn exc/dstr ntra-abd >30 cm

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How to Reduce Your Cost for Opn exc/dstr ntra-abd >30 cm

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

48.75
Work RVU
19.26
Practice Expense RVU
11.04
Malpractice RVU
79.05
Total RVU

Payment = Total RVU (79.05) x CF ($33.40) = $2,640

Frequently Asked Questions

How much does Opn exc/dstr ntra-abd >30 cm cost?

The Medicare facility rate for Opn exc/dstr ntra-abd >30 cm is $2,640. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Opn exc/dstr ntra-abd >30 cm cost without insurance?

Without insurance, the cost of Opn exc/dstr ntra-abd >30 cm can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Opn exc/dstr ntra-abd >30 cm?

Most commercial health insurance plans and Medicare cover Opn exc/dstr ntra-abd >30 cm when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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