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

Needle drainage of peritoneal fluid without imaging guidance for diagnostic sampling or relief of ascites is reported with CPT 49082.

CMS RVU26DEffective Oct 1, 2026One payment locality8.4K Medicare services in 2024

In Delaware, Medicare pays $242.31 for 49082 in the office and $70.38 when it’s performed in a hospital or facility.

$242.31Office (non-facility)
$70.38Hospital or facility
−1.2%vs the national office rate ($245.16)

Check a contract rate as a % of Medicare · 49082 nationwide

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

We’ll open 49082 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 49082 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Delaware compares for 49082

Across 109 of 109 payment localities, the office rate for 49082 runs from $214.00 in Arkansas to $334.05 in San Benito County, CA. Delaware pays $242.31. The RVUs are the same everywhere; the geographic indexes change the dollars.

49082 in Delaware vs other payment areas
  1. Delaware · this page$242.31
  2. Los Angeles, CA · California$280.82+$38.51
  3. Washington, DC area · District of Columbia$283.36+$41.05
  4. Miami, FL · Florida$263.50+$21.19
  5. Chicago, IL · Illinois$255.09+$12.78
  6. Manhattan, NY · New York$283.75+$41.44
  7. Alaska · Alaska$275.25+$32.94

Other areas in Delaware first, then benchmark localities. Bars start at $0.

Every other payment area

49082 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$217.50$65.24
ArkansasArkansas$214.00$64.51
ArizonaArizona$238.06$69.44
Bakersfield, CACalifornia$262.33$71.61
Chico, CACalifornia$261.76$71.04
El Centro, CACalifornia$261.80$71.07
Fresno, CACalifornia$261.76$71.04
Hanford, CACalifornia$261.76$71.04

49082 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$214.00

$297.91

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
49082 office rate range by state
State / territoryOffice rate rangeLocalities
AK$275.251
AL$217.501
AR$214.001
AZ$238.061
CA$261.76–$334.0529
CO$256.861
CT$262.621
DC$283.361
DE$242.311
FL$239.81–$263.503
GA$225.05–$249.802
GU$269.491
HI$269.491
IA$224.301
ID$225.801
IL$231.69–$255.954
IN$227.271
KS$222.831
KY$222.611
LA$222.10–$234.392
MA$254.95–$284.512
MD$247.40–$283.363
ME$226.79–$240.922
MI$228.79–$242.812
MN$246.201
MO$217.66–$235.673
MS$215.891
MT$245.151
NC$229.481
ND$241.191
NE$225.761
NH$252.451
NJ$265.65–$279.852
NM$230.071
NV$244.251
NY$233.28–$290.915
OH$227.981
OK$222.481
OR$242.39–$266.082
PA$228.55–$255.302
PR$247.241
RI$251.751
SC$229.111
SD$240.731
TN$224.051
TX$226.86–$255.978
UT$232.601
VA$239.83–$283.362
VI$247.241
VT$239.881
WA$254.59–$290.922
WI$232.221
WV$222.091
WY$243.431

See 49082 in every payment locality

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.

How the rate is built · 49082

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.21

1.21 RVUs× 1.000 GPCI

Practice expense5.93

5.93 RVUs× 1.000 GPCI

Malpractice0.20

0.20 RVUs× 1.000 GPCI

Adjusted RVUs

7.3400

Conversion factor

$33.4009

Medicare rate

$245.16

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,770

Code
49082
Physician work
1.21
Practice expense
5.93
Malpractice
0.20

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 49082 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.21× 1.0051.2160
Practice expense5.93× 0.9885.8588
Malpractice0.20× 0.8990.1798
Total RVUs7.2547
Conversion factor× 33.4009

Office rate, Delaware$242.31

Office: (1.21 × 1.005 + 5.93 × 0.988 + 0.2 × 0.899) × $33.4009 = $242.31

Facility: (1.21 × 1.005 + 0.72 × 0.988 + 0.2 × 0.899) × $33.4009 = $70.38

Open 49082 in the RVU calculator

Payment rules and modifiers for 49082

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

CMS payment indicators · 49082

Paracentesis, without imaging guidance

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49082 without 51 · national office

$245.16

Paracentesis, without imaging guidance

49082-51 · Second procedure: 50%

$122.58

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 49082

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

Codes related to 49082
CodeHow it relatesOffice range, Delaware
Same family
49083Paracentesis, with imaging guidanceParacentesis performed with imaging guidance.$281.31
Often billed with
89051Body fluid count, with cell identificationMay report a separately performed cell count on the ascitic-fluid specimen.$5.60
82042Fluid albumin, CSF or amniotic fluidMay report a separately performed albumin measurement on the fluid specimen.$7.78

How 49082 has changed in Delaware

49082 · Office / nonfacility

$242.31

Effective 2026-10-01

The base rate is $43.26 higher than on 2025-10-01, moving from $199.05 to $242.31 (21.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $199.05changed to$242.31

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.24 changed to 1.21
    • Practice expense RVU 4.77 changed to 5.93
    • Malpractice RVU 0.18 changed to 0.20
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $210.11changed to$199.05

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.92 changed to 4.77
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $206.68changed to$210.11

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $217.27changed to$206.68

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.95 changed to 4.92
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $227.83changed to$217.27

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.05 changed to 4.95
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $229.43changed to$227.83

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.06 changed to 5.05
    • Malpractice RVU 0.17 changed to 0.19

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $213.79changed to$229.43

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.40 changed to 5.06
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $208.26changed to$213.79

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.27 changed to 4.40
    • Malpractice RVU 0.16 changed to 0.18
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $204.00changed to$208.26

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.16 changed to 4.27

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $201.36changed to$204.00

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.08 changed to 4.16
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $201.01changed to$201.36

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.06 changed to 4.08
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $203.60changed to$201.01

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.10 changed to 4.06
    • Malpractice RVU 0.17 changed to 0.16

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $202.59changed to$203.60

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $198.64changed to$202.59

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.04 changed to 4.10
    • Malpractice RVU 0.11 changed to 0.17
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $185.87changed to$198.64

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.96 changed to 4.04
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $185.87

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$242.31$70.38RVU26D
2026-07-01$242.31$70.38RVU26C
2026-04-01$242.31$70.38RVU26B
2026-01-01$242.31$70.38RVU26A
2025-10-01$199.05$70.38RVU25D
2025-07-01$199.05$70.38RVU25C
2025-04-01$199.05$70.38RVU25B
2025-01-01$199.05$70.38RVU25A
2024-10-01$210.11$72.42RVU24D
2024-07-01$210.11$72.42RVU24C
2024-04-01$210.11$72.42RVU24B
2024-03-09$210.11$72.42RVU24AR
2024-01-01$206.68$71.23RVU24A
2023-10-01$217.27$73.26RVU23D
2023-07-01$217.27$73.26RVU23C
2023-04-01$217.27$73.26RVU23B
2023-01-01$217.27$73.26RVU23A
2022-10-01$227.83$75.04RVU22D
2022-07-01$227.83$75.04RVU22C
2022-04-01$227.83$75.04RVU22B
2022-01-01$227.83$75.04RVU22A
2021-10-01$229.43$74.66RVU21D
2021-07-01$229.43$74.66RVU21C
2021-04-01$229.43$74.66RVU21B
2021-01-01$229.43$74.66RVU21A
2020-10-01$213.79$78.20RVU20D
2020-07-01$213.79$78.20RVU20C
2020-04-01$213.79$78.20RVU20B
2020-01-01$213.79$78.20RVU20A
2019-10-01$208.26$77.89RVU19D
2019-07-01$208.26$77.89RVU19C
2019-04-01$208.26$77.89RVU19B
2019-01-01$208.26$77.89RVU19A
2018-10-01$204.00$78.54RVU18D
2018-07-01$204.00$78.54RVU18C
2018-04-01$204.00$78.54RVU18B
2018-01-01$204.00$78.54RVU18AR1
2017-10-01$201.36$78.86RVU17D
2017-07-01$201.36$78.86RVU17C
2017-04-01$201.36$78.86RVU17B
2017-01-01$201.36$78.86RVU17A
2016-10-01$201.01$78.82RVU16D
2016-07-01$201.01$78.82RVU16C
2016-04-01$201.01$78.82RVU16B
2016-01-01$201.01$78.82RVU16A
2015-10-01$203.60$79.86RVU15D
2015-07-01$203.60$79.86RVU15C
2015-04-01$202.59$79.47RVU15B
2015-01-01$202.59$79.47RVU15A
2014-10-01$198.64$77.04RVU14D
2014-07-01$198.64$77.04RVU14C
2014-04-01$198.64$77.04RVU14B
2014-01-01$198.64$77.04RVU14A
2013-10-01$185.87$72.92RVU13D
2013-07-01$185.87$72.92RVU13C
2013-04-01$185.87$72.92RVU13B
2013-01-01$185.87$72.92RVU13AR

Price 49082 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

49082 billing questions

When should I report 49083 instead?

Report 49083 when imaging guidance is used for the paracentesis. Use 49082 when the procedure is performed without imaging guidance.

Can the ascitic-fluid tests be billed separately?

Yes. Separately performed laboratory testing, such as a fluid cell count or albumin measurement, may be reported under the applicable laboratory codes.

Is modifier 50 appropriate for bilateral paracentesis?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How many units should be reported when a large volume is removed?

Report the procedure, not a unit for each volume removed. Document the amount drained, but do not use the volume as the unit count.

Does the code include same-day care?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

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

Show the CMS file lines behind this rate
RVUs for 49082PPRRVU2026_Oct_nonQPP.csv, line 5,770 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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