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CPT code 49082: Paracentesis, without imaging guidance2026 Medicare rate & RVUs in Fort Worth, TX

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 Fort Worth, TX, Medicare pays $241.89 for 49082 in the office and $70.31 when it’s performed in a hospital or facility.

$241.89Office (non-facility)
$70.31Hospital or facility
−1.3%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 Fort Worth, TX
  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 Fort Worth, TX 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. Fort Worth, TX pays $241.89. The RVUs are the same everywhere; the geographic indexes change the dollars.

49082 in Fort Worth, TX vs other payment areas
  1. Fort Worth, TX · this page$241.89
  2. Austin, TX · Texas$255.97+$14.08
  3. Beaumont, TX · Texas$226.86−$15.03
  4. Brazoria, TX · Texas$242.23+$0.34
  5. Dallas, TX · Texas$243.79+$1.90
  6. Galveston, TX · Texas$242.95+$1.06
  7. Houston, TX · Texas$246.61+$4.72

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

Every other payment area

49082 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$234.41$69.27
Los Angeles, CACalifornia$280.82$74.96
Washington, DC areaDistrict of Columbia$283.36$78.36
Miami, FLFlorida$263.50$82.34
Chicago, ILIllinois$255.09$80.20
Manhattan, NYNew York$283.75$81.54
AlaskaAlaska$275.25$89.92
AlabamaAlabama$217.50$65.24

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 Fort Worth, TX 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

100

Locality
Fort Worth, TX
Physician work
1.009
Practice expense
0.986
Malpractice
0.871
Office calculation for 49082 in Fort Worth, TX
ComponentRVULocality factorAdjusted
Physician work1.21× 1.0091.2209
Practice expense5.93× 0.9865.8470
Malpractice0.20× 0.8710.1742
Total RVUs7.2421
Conversion factor× 33.4009

Office rate, Fort Worth, TX$241.89

Office: (1.21 × 1.009 + 5.93 × 0.986 + 0.2 × 0.871) × $33.4009 = $241.89

Facility: (1.21 × 1.009 + 0.72 × 0.986 + 0.2 × 0.871) × $33.4009 = $70.31

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, Fort Worth, TX
Same family
49083Paracentesis, with imaging guidanceParacentesis performed with imaging guidance.$280.95
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 Fort Worth, TX

49082 · Office / nonfacility

$241.89

Effective 2026-10-01

The base rate is $42.10 higher than on 2025-10-01, moving from $199.79 to $241.89 (21.1%).

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

    $199.79changed to$241.89

    • 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 1.011 changed to 1.009
    • Practice expense GPCI 0.998 changed to 0.986
    • Malpractice GPCI 0.902 changed to 0.871

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $210.88changed to$199.79

    • 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

    $207.44changed to$210.88

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $214.28changed to$207.44

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.95 changed to 4.92
    • Work GPCI 1.013 changed to 1.011
    • Practice expense GPCI 0.996 changed to 0.998
    • Malpractice GPCI 0.721 changed to 0.902

  5. January 1, 2023

    RVU23A

    $221.03changed to$214.28

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.05 changed to 4.95
    • Work GPCI 1.016 changed to 1.013
    • Practice expense GPCI 0.995 changed to 0.996
    • Malpractice GPCI 0.539 changed to 0.721

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $222.83changed to$221.03

    • 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

    $206.79changed to$222.83

    • 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 1.011 changed to 1.016
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.643 changed to 0.539

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $201.04changed to$206.79

    • 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 1.011
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.747 changed to 0.643

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $196.92changed to$201.04

    • 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

    $194.24changed to$196.92

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.08 changed to 4.16
    • Work GPCI 1.006 changed to 1.007
    • Practice expense GPCI 0.991 changed to 0.986
    • Malpractice GPCI 0.760 changed to 0.747

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $193.68changed to$194.24

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.06 changed to 4.08
    • Work GPCI 1.005 changed to 1.006
    • Practice expense GPCI 0.995 changed to 0.991
    • Malpractice GPCI 0.772 changed to 0.760

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $196.09changed to$193.68

    • 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

    $195.11changed to$196.09

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $190.50changed to$195.11

    • 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
    • Work GPCI 1.002 changed to 1.005
    • Practice expense GPCI 0.987 changed to 0.995
    • Malpractice GPCI 0.799 changed to 0.772

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $177.18changed to$190.50

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.96 changed to 4.04
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.979 changed to 0.987
    • Malpractice GPCI 0.826 changed to 0.799

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $177.18

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$241.89$70.31RVU26D
2026-07-01$241.89$70.31RVU26C
2026-04-01$241.89$70.31RVU26B
2026-01-01$241.89$70.31RVU26A
2025-10-01$199.79$70.34RVU25D
2025-07-01$199.79$70.34RVU25C
2025-04-01$199.79$70.34RVU25B
2025-01-01$199.79$70.34RVU25A
2024-10-01$210.88$72.35RVU24D
2024-07-01$210.88$72.35RVU24C
2024-04-01$210.88$72.35RVU24B
2024-03-09$210.88$72.35RVU24AR
2024-01-01$207.44$71.17RVU24A
2023-10-01$214.28$71.85RVU23D
2023-07-01$214.28$71.85RVU23C
2023-04-01$214.28$71.85RVU23B
2023-01-01$214.28$71.85RVU23A
2022-10-01$221.03$72.28RVU22D
2022-07-01$221.03$72.28RVU22C
2022-04-01$221.03$72.28RVU22B
2022-01-01$221.03$72.28RVU22A
2021-10-01$222.83$72.15RVU21D
2021-07-01$222.83$72.15RVU21C
2021-04-01$222.83$72.15RVU21B
2021-01-01$222.83$72.15RVU21A
2020-10-01$206.79$75.17RVU20D
2020-07-01$206.79$75.17RVU20C
2020-04-01$206.79$75.17RVU20B
2020-01-01$206.79$75.17RVU20A
2019-10-01$201.04$74.89RVU19D
2019-07-01$201.04$74.89RVU19C
2019-04-01$201.04$74.89RVU19B
2019-01-01$201.04$74.89RVU19A
2018-10-01$196.92$75.52RVU18D
2018-07-01$196.92$75.52RVU18C
2018-04-01$196.92$75.52RVU18B
2018-01-01$196.92$75.52RVU18AR1
2017-10-01$194.24$75.81RVU17D
2017-07-01$194.24$75.81RVU17C
2017-04-01$194.24$75.81RVU17B
2017-01-01$194.24$75.81RVU17A
2016-10-01$193.68$75.76RVU16D
2016-07-01$193.68$75.76RVU16C
2016-04-01$193.68$75.76RVU16B
2016-01-01$193.68$75.76RVU16A
2015-10-01$196.09$76.67RVU15D
2015-07-01$196.09$76.67RVU15C
2015-04-01$195.11$76.29RVU15B
2015-01-01$195.11$76.29RVU15A
2014-10-01$190.50$74.88RVU14D
2014-07-01$190.50$74.88RVU14C
2014-04-01$190.50$74.88RVU14B
2014-01-01$190.50$74.88RVU14A
2013-10-01$177.18$71.26RVU13D
2013-07-01$177.18$71.26RVU13C
2013-04-01$177.18$71.26RVU13B
2013-01-01$177.18$71.26RVU13AR

Price 49082 for an earlier date of service

Where the Fort Worth, TX rate applies

Fort Worth, TX is a Medicare payment area, not a city. Our Census mapping connects it to 45 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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 Fort Worth, TXGPCI2026.csv, line 100 (RVU26D)

Open CMS sourceHow we calculate rates

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