CPT code 49000: Abdominal exploration, open laparotomy2026 Medicare rate & RVUs

Medicare pays $728.81 for 49000 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 49000 covers

A surgeon opens the abdomen to inspect the abdominal cavity and its organs when the cause or extent of a problem is uncertain. General and trauma surgeons may perform this exploration in a hospital operating room for situations such as suspected internal injury or an acute abdominal condition. Tissue sampling may be part of the examination. The service represents an operative exploration, not simply visual inspection during another abdominal operation.

Report the exploration when it is the operative service performed; if a more definitive intra-abdominal operation is completed during the same session, the preliminary survey is included in that operation. The operative report should establish why exploration was needed, what areas were examined, and whether additional treatment or biopsy occurred. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 49000 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

49000 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 49000 rate is calculated

Each of 49000’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 49000

49000 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

49000 compared with similar codes

How to choose

49002Abdominal reoperationRecent laparotomy

49000 describes an initial open abdominal exploration; 49002 is for reopening a prior abdominal incision to explore.

49010Retroperitoneal explorationWith or without biopsy

49000 concerns exploration of the abdominal cavity. 49010 is selected when the operative exploration is in the retroperitoneal space.

49020Abscess drainageOpen peritoneal approach

Choose 49020 when the operation is open drainage of an abdominal abscess. 49000 describes exploration rather than abscess drainage as the operative objective.

49040Abscess drainageOpen abdominal approach

49040 describes open drainage of a localized abdominal abscess; 49000 is for an open abdominal exploration without that drainage service as the defining objective.

Codes related to 49000

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates