CPT code 49082: Paracentesis, without imaging guidance2026 Medicare rate & RVUs in Iowa
Needle drainage of peritoneal fluid without imaging guidance for diagnostic sampling or relief of ascites is reported with CPT 49082.
In Iowa, Medicare pays $224.30 for 49082 in the office and $65.07 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Iowa 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. Iowa pays $224.30. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$224.30
- Los Angeles, CA · California$280.82+$56.52
- Washington, DC area · District of Columbia$283.36+$59.06
- Miami, FL · Florida$263.50+$39.20
- Chicago, IL · Illinois$255.09+$30.79
- Manhattan, NY · New York$283.75+$59.45
- Alaska · Alaska$275.25+$50.95
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $261.76 | $71.04 |
| Merced, CACalifornia | $261.76 | $71.04 |
| Modesto, CACalifornia | $261.76 | $71.04 |
| Napa, CACalifornia | $307.41 | $78.05 |
| Oxnard, CACalifornia | $279.82 | $74.13 |
| Redding, CACalifornia | $261.76 | $71.04 |
| Rest of CaliforniaCalifornia | $261.76 | $71.04 |
| Riverside, CACalifornia | $263.92 | $73.20 |
| Sacramento, CACalifornia | $275.80 | $73.42 |
| Salinas, CACalifornia | $274.81 | $73.12 |
| San Diego, CACalifornia | $282.14 | $74.01 |
| Marin County, CACalifornia | $326.60 | $81.23 |
| San Francisco, CACalifornia | $326.37 | $81.00 |
| San Benito County, CACalifornia | $334.05 | $83.12 |
| Santa Clara County, CACalifornia | $333.13 | $82.19 |
| San Luis Obispo, CACalifornia | $270.28 | $72.07 |
| Santa Cruz, CACalifornia | $285.50 | $74.06 |
| Santa Maria, CACalifornia | $276.07 | $73.17 |
| Santa Rosa, CACalifornia | $288.43 | $74.74 |
| Stockton, CACalifornia | $261.76 | $71.04 |
| Vallejo, CACalifornia | $307.08 | $77.72 |
| Visalia, CACalifornia | $261.76 | $71.04 |
| Yuba City, CACalifornia | $261.76 | $71.04 |
| ColoradoColorado | $256.86 | $71.71 |
| ConnecticutConnecticut | $262.62 | $75.21 |
| DelawareDelaware | $242.31 | $70.38 |
| Fort Lauderdale, FLFlorida | $253.14 | $76.85 |
| Rest of FloridaFlorida | $239.81 | $73.45 |
| Atlanta, GAGeorgia | $249.80 | $72.99 |
| Rest of GeorgiaGeorgia | $225.05 | $69.83 |
| Hawaii, Guam, HIHawaii | $269.49 | $71.63 |
| IdahoIdaho | $225.80 | $65.70 |
| East St. Louis, ILIllinois | $236.09 | $75.99 |
| Rest of IllinoisIllinois | $231.69 | $72.81 |
| Suburban Chicago, ILIllinois | $255.95 | $77.23 |
| IndianaIndiana | $227.27 | $65.95 |
| KansasKansas | $222.83 | $65.52 |
| KentuckyKentucky | $222.61 | $67.91 |
| New Orleans, LALouisiana | $234.39 | $70.63 |
| Rest of LouisianaLouisiana | $222.10 | $68.10 |
| Metropolitan Boston, MAMassachusetts | $284.51 | $76.73 |
| Rest of MassachusettsMassachusetts | $254.95 | $71.71 |
| Baltimore area, MDMaryland | $261.85 | $75.13 |
| Rest of MarylandMaryland | $247.40 | $71.29 |
| Rest of MaineMaine | $226.79 | $66.69 |
| Southern Maine, MEMaine | $240.92 | $68.46 |
| Detroit, MIMichigan | $242.81 | $74.88 |
| Rest of MichiganMichigan | $228.79 | $69.91 |
| MinnesotaMinnesota | $246.20 | $67.14 |
| Metropolitan Kansas City, MOMissouri | $232.93 | $69.52 |
| Metropolitan St. Louis, MOMissouri | $235.67 | $70.00 |
| Rest of MissouriMissouri | $217.66 | $67.65 |
| MississippiMississippi | $215.89 | $66.06 |
| MontanaMontana | $245.15 | $71.13 |
| North CarolinaNorth Carolina | $229.48 | $67.12 |
| North DakotaNorth Dakota | $241.19 | $67.18 |
| NebraskaNebraska | $225.76 | $65.14 |
| New HampshireNew Hampshire | $252.45 | $71.29 |
| Northern New JerseyNew Jersey | $279.85 | $77.99 |
| Rest of New JerseyNew Jersey | $265.65 | $75.62 |
| New MexicoNew Mexico | $230.07 | $70.49 |
| NevadaNevada | $244.25 | $70.05 |
| NYC suburbs and Long Island, NYNew York | $290.91 | $84.00 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $267.20 | $76.65 |
| Queens, NYNew York | $286.75 | $81.06 |
| Rest of New YorkNew York | $233.28 | $67.96 |
| OhioOhio | $227.98 | $69.11 |
| OklahomaOklahoma | $222.48 | $67.08 |
| Portland, OROregon | $266.08 | $72.75 |
| Rest of OregonOregon | $242.39 | $69.06 |
| Metropolitan Philadelphia, PAPennsylvania | $255.30 | $74.15 |
| Rest of PennsylvaniaPennsylvania | $228.55 | $68.80 |
| Puerto RicoPuerto Rico | $247.24 | $71.31 |
| Rhode IslandRhode Island | $251.75 | $71.98 |
| South CarolinaSouth Carolina | $229.11 | $68.31 |
| South DakotaSouth Dakota | $240.73 | $66.71 |
| TennesseeTennessee | $224.05 | $65.86 |
| Austin, TXTexas | $255.97 | $71.86 |
| Beaumont, TXTexas | $226.86 | $68.51 |
| Brazoria, TXTexas | $242.23 | $69.78 |
| Dallas, TXTexas | $243.79 | $70.46 |
| Fort Worth, TXTexas | $241.89 | $70.31 |
| Galveston, TXTexas | $242.95 | $70.15 |
| Houston, TXTexas | $246.61 | $73.81 |
| Rest of TexasTexas | $234.41 | $69.27 |
| UtahUtah | $232.60 | $69.02 |
| VirginiaVirginia | $239.83 | $68.77 |
| Virgin Islands, VIUnited States Virgin Islands | $247.24 | $71.31 |
| VermontVermont | $239.88 | $67.60 |
| Rest of WashingtonWashington | $254.59 | $71.35 |
| King County, WAWashington | $290.92 | $77.40 |
| WisconsinWisconsin | $232.22 | $65.51 |
| West VirginiaWest Virginia | $222.09 | $70.87 |
| WyomingWyoming | $243.43 | $69.41 |
49082 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $275.25 | 1 |
| AL | $217.50 | 1 |
| AR | $214.00 | 1 |
| AZ | $238.06 | 1 |
| CA | $261.76–$334.05 | 29 |
| CO | $256.86 | 1 |
| CT | $262.62 | 1 |
| DC | $283.36 | 1 |
| DE | $242.31 | 1 |
| FL | $239.81–$263.50 | 3 |
| GA | $225.05–$249.80 | 2 |
| GU | $269.49 | 1 |
| HI | $269.49 | 1 |
| IA | $224.30 | 1 |
| ID | $225.80 | 1 |
| IL | $231.69–$255.95 | 4 |
| IN | $227.27 | 1 |
| KS | $222.83 | 1 |
| KY | $222.61 | 1 |
| LA | $222.10–$234.39 | 2 |
| MA | $254.95–$284.51 | 2 |
| MD | $247.40–$283.36 | 3 |
| ME | $226.79–$240.92 | 2 |
| MI | $228.79–$242.81 | 2 |
| MN | $246.20 | 1 |
| MO | $217.66–$235.67 | 3 |
| MS | $215.89 | 1 |
| MT | $245.15 | 1 |
| NC | $229.48 | 1 |
| ND | $241.19 | 1 |
| NE | $225.76 | 1 |
| NH | $252.45 | 1 |
| NJ | $265.65–$279.85 | 2 |
| NM | $230.07 | 1 |
| NV | $244.25 | 1 |
| NY | $233.28–$290.91 | 5 |
| OH | $227.98 | 1 |
| OK | $222.48 | 1 |
| OR | $242.39–$266.08 | 2 |
| PA | $228.55–$255.30 | 2 |
| PR | $247.24 | 1 |
| RI | $251.75 | 1 |
| SC | $229.11 | 1 |
| SD | $240.73 | 1 |
| TN | $224.05 | 1 |
| TX | $226.86–$255.97 | 8 |
| UT | $232.60 | 1 |
| VA | $239.83–$283.36 | 2 |
| VI | $247.24 | 1 |
| VT | $239.88 | 1 |
| WA | $254.59–$290.92 | 2 |
| WI | $232.22 | 1 |
| WV | $222.09 | 1 |
| WY | $243.43 | 1 |
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
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 Iowa 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
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.21 | × 1.000 | 1.2100 |
| Practice expense | 5.93 | × 0.915 | 5.4260 |
| Malpractice | 0.20 | × 0.397 | 0.0794 |
| Total RVUs | 6.7153 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$224.30
Office: (1.21 × 1 + 5.93 × 0.915 + 0.2 × 0.397) × $33.4009 = $224.30
Facility: (1.21 × 1 + 0.72 × 0.915 + 0.2 × 0.397) × $33.4009 = $65.07
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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%).
How 49082 has changed in Iowa
49082 · Office / nonfacility
$224.30
Effective 2026-10-01
The base rate is $40.66 higher than on 2025-10-01, moving from $183.64 to $224.30 (22.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$183.64changed to$224.30
- 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
- Practice expense GPCI 0.913 changed to 0.915
- Malpractice GPCI 0.457 changed to 0.397
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$193.69changed to$183.64
- 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.
March 9, 2024
RVU24AR
$190.53changed to$193.69
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$197.50changed to$190.53
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 4.95 changed to 4.92
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$204.21changed to$197.50
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 5.05 changed to 4.95
- Practice expense GPCI 0.907 changed to 0.910
- Malpractice GPCI 0.425 changed to 0.441
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$205.93changed to$204.21
- 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.
January 1, 2021
RVU21A
$191.53changed to$205.93
- 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
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$186.70changed to$191.53
- 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
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$182.91changed to$186.70
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 4.16 changed to 4.27
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$179.21changed to$182.91
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 4.08 changed to 4.16
- Practice expense GPCI 0.902 changed to 0.907
- Malpractice GPCI 0.458 changed to 0.423
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$177.47changed to$179.21
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 4.06 changed to 4.08
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 0.493 changed to 0.458
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$179.57changed to$177.47
- 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.
July 1, 2015
RVU15C
$178.68changed to$179.57
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$175.39changed to$178.68
- 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 0.892 changed to 0.896
- Malpractice GPCI 0.475 changed to 0.493
Held through RVU15B.
January 1, 2014
RVU14A
$163.40changed to$175.39
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 3.96 changed to 4.04
- Practice expense GPCI 0.887 changed to 0.892
- Malpractice GPCI 0.456 changed to 0.475
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $163.40
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $224.30 | $65.07 | RVU26D |
| 2026-07-01 | $224.30 | $65.07 | RVU26C |
| 2026-04-01 | $224.30 | $65.07 | RVU26B |
| 2026-01-01 | $224.30 | $65.07 | RVU26A |
| 2025-10-01 | $183.64 | $65.22 | RVU25D |
| 2025-07-01 | $183.64 | $65.22 | RVU25C |
| 2025-04-01 | $183.64 | $65.22 | RVU25B |
| 2025-01-01 | $183.64 | $65.22 | RVU25A |
| 2024-10-01 | $193.69 | $66.96 | RVU24D |
| 2024-07-01 | $193.69 | $66.96 | RVU24C |
| 2024-04-01 | $193.69 | $66.96 | RVU24B |
| 2024-03-09 | $193.69 | $66.96 | RVU24AR |
| 2024-01-01 | $190.53 | $65.87 | RVU24A |
| 2023-10-01 | $197.50 | $67.37 | RVU23D |
| 2023-07-01 | $197.50 | $67.37 | RVU23C |
| 2023-04-01 | $197.50 | $67.37 | RVU23B |
| 2023-01-01 | $197.50 | $67.37 | RVU23A |
| 2022-10-01 | $204.21 | $68.62 | RVU22D |
| 2022-07-01 | $204.21 | $68.62 | RVU22C |
| 2022-04-01 | $204.21 | $68.62 | RVU22B |
| 2022-01-01 | $204.21 | $68.62 | RVU22A |
| 2021-10-01 | $205.93 | $68.58 | RVU21D |
| 2021-07-01 | $205.93 | $68.58 | RVU21C |
| 2021-04-01 | $205.93 | $68.58 | RVU21B |
| 2021-01-01 | $205.93 | $68.58 | RVU21A |
| 2020-10-01 | $191.53 | $71.07 | RVU20D |
| 2020-07-01 | $191.53 | $71.07 | RVU20C |
| 2020-04-01 | $191.53 | $71.07 | RVU20B |
| 2020-01-01 | $191.53 | $71.07 | RVU20A |
| 2019-10-01 | $186.70 | $70.66 | RVU19D |
| 2019-07-01 | $186.70 | $70.66 | RVU19C |
| 2019-04-01 | $186.70 | $70.66 | RVU19B |
| 2019-01-01 | $186.70 | $70.66 | RVU19A |
| 2018-10-01 | $182.91 | $71.24 | RVU18D |
| 2018-07-01 | $182.91 | $71.24 | RVU18C |
| 2018-04-01 | $182.91 | $71.24 | RVU18B |
| 2018-01-01 | $182.91 | $71.24 | RVU18AR1 |
| 2017-10-01 | $179.21 | $71.41 | RVU17D |
| 2017-07-01 | $179.21 | $71.41 | RVU17C |
| 2017-04-01 | $179.21 | $71.41 | RVU17B |
| 2017-01-01 | $179.21 | $71.41 | RVU17A |
| 2016-10-01 | $177.47 | $71.28 | RVU16D |
| 2016-07-01 | $177.47 | $71.28 | RVU16C |
| 2016-04-01 | $177.47 | $71.28 | RVU16B |
| 2016-01-01 | $177.47 | $71.28 | RVU16A |
| 2015-10-01 | $179.57 | $72.04 | RVU15D |
| 2015-07-01 | $179.57 | $72.04 | RVU15C |
| 2015-04-01 | $178.68 | $71.68 | RVU15B |
| 2015-01-01 | $178.68 | $71.68 | RVU15A |
| 2014-10-01 | $175.39 | $70.90 | RVU14D |
| 2014-07-01 | $175.39 | $70.90 | RVU14C |
| 2014-04-01 | $175.39 | $70.90 | RVU14B |
| 2014-01-01 | $175.39 | $70.90 | RVU14A |
| 2013-10-01 | $163.40 | $67.43 | RVU13D |
| 2013-07-01 | $163.40 | $67.43 | RVU13C |
| 2013-04-01 | $163.40 | $67.43 | RVU13B |
| 2013-01-01 | $163.40 | $67.43 | RVU13AR |
Where the Iowa rate applies
Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.
- Ackley
- Ackworth
- Adair
- Adel
- Afton
- Agency
- Ainsworth
- Akron
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
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