CPT code 49082: Paracentesis, without imaging guidance2026 Medicare rate & RVUs

Medicare pays $245.16 for 49082 nationally in the office and $71.14 in a hospital or facility. Local office rates run $214.00–$334.05.

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

What 49082 covers

49082 represents needle or catheter entry through the abdominal wall into the peritoneal cavity to withdraw ascitic fluid without imaging guidance. The procedure may be diagnostic, such as sampling new or worsening ascites for evaluation, or therapeutic to relieve symptomatic fluid accumulation, including ascites associated with cirrhosis or malignancy. Physicians commonly perform it at the bedside or in hospital and clinic settings.

Choose 49082 when the tap is performed without imaging guidance; when imaging guides the procedure, report 49083 instead. Documentation should identify the indication, technique, fluid obtained, amount removed, and whether a specimen was sent for testing. Separately performed laboratory analysis is reported under the applicable lab codes. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, CMS pays the highest-valued procedure in full and the others at 50%. Modifier 50 is inappropriate. CMS does not pay an assistant at surgery; co-surgeons and team surgery are 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 49082 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

49082 rates by state

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

How the 49082 rate is calculated

Each of 49082’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 49082

The CMS indicators that decide how 49082 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

49082 compared with similar codes

How to choose

49083ParacentesisWith imaging guidance

Use 49083 when imaging guidance is used for the paracentesis; 49082 describes the procedure without imaging guidance.

49084Peritoneal lavageDiagnostic abdominal fluid lavage

49084 describes peritoneal lavage, a washout procedure. Paracentesis withdraws ascitic fluid for sampling or symptom relief.

49020Abscess drainageOpen peritoneal approach

49020 is open drainage of an abdominal abscess. It is not the needle or catheter removal of ascitic fluid described by 49082.

Codes related to 49082

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