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CPT code 49083: Paracentesis, with imaging guidance2026 Medicare rate & RVUs in Virginia

Report image-guided abdominal paracentesis when a clinician removes peritoneal fluid for diagnosis or symptom relief using imaging to guide needle placement.

CMS RVU26DEffective Oct 1, 2026One payment locality235.4K Medicare services in 2024

In Virginia, Medicare pays $278.57 for 49083 in the office and $90.44 when it’s performed in a hospital or facility.

$278.57Office (non-facility)
$90.44Hospital or facility
−2.0%vs the national office rate ($284.24)

Check a contract rate as a % of Medicare · 49083 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 49083 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 49083 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 49083 covers

A clinician uses imaging, commonly ultrasound, to guide a needle or catheter into the peritoneal cavity and remove ascitic fluid. The procedure may obtain fluid for diagnostic testing or relieve symptoms from fluid accumulation, such as abdominal distention or discomfort. It is performed in settings including hospitals, outpatient departments, and offices by physicians or other qualified practitioners who perform paracentesis.

Select 49083 when imaging guidance is used; 49082 is the corresponding code for paracentesis without imaging guidance. Documentation should support the indication, fluid removal, and use of imaging to guide the procedure. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and 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 Virginia compares for 49083

Across 109 of 109 payment localities, the office rate for 49083 runs from $250.93 in Arkansas to $381.90 in San Benito County, CA. Virginia pays $278.57. The RVUs are the same everywhere; the geographic indexes change the dollars.

49083 in Virginia vs other payment areas
  1. Virginia · this page$278.57
  2. Los Angeles, CA · California$323.37+$44.80
  3. Washington, DC area · District of Columbia$326.30+$47.73
  4. Miami, FL · Florida$303.66+$25.09
  5. Chicago, IL · Illinois$294.84+$16.27
  6. Manhattan, NY · New York$326.88+$48.31
  7. Alaska · Alaska$327.44+$48.87

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

Every other payment area

49083 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$254.69$87.22
ArkansasArkansas$250.93$86.53
ArizonaArizona$276.66$91.20
Bakersfield, CACalifornia$303.10$93.34
Chico, CACalifornia$302.46$92.70
El Centro, CACalifornia$302.49$92.73
Fresno, CACalifornia$302.46$92.70
Hanford, CACalifornia$302.46$92.70

49083 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.

$250.93

$342.18

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

View every state and territory as a table
49083 office rate range by state
State / territoryOffice rate rangeLocalities
AK$327.441
AL$254.691
AR$250.931
AZ$276.661
CA$302.46–$381.9029
CO$297.061
CT$303.351
DC$326.301
DE$281.311
FL$278.44–$303.663
GA$262.68–$289.242
GU$310.351
HI$310.351
IA$261.981
ID$263.581
IL$269.74–$295.844
IN$265.151
KS$260.401
KY$260.101
LA$259.56–$272.682
MA$295.10–$327.292
MD$286.86–$326.303
ME$264.62–$279.742
MI$266.69–$281.632
MN$285.451
MO$254.79–$274.083
MS$252.931
MT$284.231
NC$267.501
ND$280.081
NE$263.551
NH$292.061
NJ$307.04–$322.762
NM$268.051
NV$283.281
NY$271.55–$334.515
OH$265.851
OK$259.981
OR$281.31–$307.032
PA$266.46–$295.462
PR$286.471
RI$291.721
SC$267.071
SD$279.581
TN$261.691
TX$264.66–$295.878
UT$270.801
VA$278.57–$326.302
VI$286.471
VT$278.661
WA$294.65–$334.362
WI$270.481
WV$259.481
WY$282.421

See 49083 in every payment locality

How the 49083 rate is calculated

Each of 49083’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 · 49083

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.95

1.95 RVUs× 1.000 GPCI

Practice expense6.35

6.35 RVUs× 1.000 GPCI

Malpractice0.21

0.21 RVUs× 1.000 GPCI

Adjusted RVUs

8.5100

Conversion factor

$33.4009

Medicare rate

$284.24

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

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,771

Code
49083
Physician work
1.95
Practice expense
6.35
Malpractice
0.21

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 49083 in Virginia
ComponentRVULocality factorAdjusted
Physician work1.95× 1.0001.9500
Practice expense6.35× 0.9836.2420
Malpractice0.21× 0.7060.1483
Total RVUs8.3403
Conversion factor× 33.4009

Office rate, Virginia$278.57

Office: (1.95 × 1 + 6.35 × 0.983 + 0.21 × 0.706) × $33.4009 = $278.57

Facility: (1.95 × 1 + 0.62 × 0.983 + 0.21 × 0.706) × $33.4009 = $90.44

Open 49083 in the RVU calculator

Payment rules and modifiers for 49083

The CMS indicators that decide how 49083 is paid alongside other services.

CMS payment indicators · 49083

Paracentesis, with 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

49083 without 51 · national office

$284.24

Paracentesis, with imaging guidance

49083-51 · Second procedure: 50%

$142.12

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 49083

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

Codes related to 49083
CodeHow it relatesOffice range, Virginia
Same family
49082Paracentesis, without imaging guidanceAbdominal paracentesis without imaging guidance.$239.83
Often billed with
88108Concentrated cytology, non-gynecologic specimenMay be reported for cytopathology of submitted fluid.$67.70
89051Body fluid count, with cell identificationMay be reported for cell count and differential on submitted body fluid.$5.60

How 49083 has changed in Virginia

49083 · Office / nonfacility

$278.57

Effective 2026-10-01

The base rate is $6.11 higher than on 2025-10-01, moving from $272.46 to $278.57 (2.2%).

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

    $272.46changed to$278.57

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.00 changed to 1.95
    • Practice expense RVU 6.37 changed to 6.35
    • Malpractice RVU 0.20 changed to 0.21
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $284.97changed to$272.46

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.51 changed to 6.37

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $280.32changed to$284.97

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $296.52changed to$280.32

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.66 changed to 6.51
    • Malpractice RVU 0.19 changed to 0.20
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $308.57changed to$296.52

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.78 changed to 6.66
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $314.67changed to$308.57

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.90 changed to 6.78
    • Malpractice RVU 0.17 changed to 0.19

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $306.22changed to$314.67

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.38 changed to 6.90
    • Malpractice RVU 0.18 changed to 0.17
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $300.41changed to$306.22

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.26 changed to 6.38
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $298.67changed to$300.41

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.22 changed to 6.26

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $295.84changed to$298.67

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.18 changed to 6.22
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $294.43changed to$295.84

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $294.73changed to$294.43

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.15 changed to 6.18
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $293.26changed to$294.73

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $294.04changed to$293.26

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.20 changed to 6.15
    • Malpractice RVU 0.17 changed to 0.19
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $318.17changed to$294.04

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.39 changed to 6.20
    • Malpractice RVU 0.18 changed to 0.17
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $318.17

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$278.57$90.44RVU26D
2026-07-01$278.57$90.44RVU26C
2026-04-01$278.57$90.44RVU26B
2026-01-01$278.57$90.44RVU26A
2025-10-01$272.46$99.94RVU25D
2025-07-01$272.46$99.94RVU25C
2025-04-01$272.46$99.94RVU25B
2025-01-01$272.46$99.94RVU25A
2024-10-01$284.97$101.87RVU24D
2024-07-01$284.97$101.87RVU24C
2024-04-01$284.97$101.87RVU24B
2024-03-09$284.97$101.87RVU24AR
2024-01-01$280.32$100.21RVU24A
2023-10-01$296.52$104.29RVU23D
2023-07-01$296.52$104.29RVU23C
2023-04-01$296.52$104.29RVU23B
2023-01-01$296.52$104.29RVU23A
2022-10-01$308.57$106.44RVU22D
2022-07-01$308.57$106.44RVU22C
2022-04-01$308.57$106.44RVU22B
2022-01-01$308.57$106.44RVU22A
2021-10-01$314.67$106.70RVU21D
2021-07-01$314.67$106.70RVU21C
2021-04-01$314.67$106.70RVU21B
2021-01-01$314.67$106.70RVU21A
2020-10-01$306.22$111.31RVU20D
2020-07-01$306.22$111.31RVU20C
2020-04-01$306.22$111.31RVU20B
2020-01-01$306.22$111.31RVU20A
2019-10-01$300.41$111.02RVU19D
2019-07-01$300.41$111.02RVU19C
2019-04-01$300.41$111.02RVU19B
2019-01-01$300.41$111.02RVU19A
2018-10-01$298.67$111.60RVU18D
2018-07-01$298.67$111.60RVU18C
2018-04-01$298.67$111.60RVU18B
2018-01-01$298.67$111.60RVU18AR1
2017-10-01$295.84$111.66RVU17D
2017-07-01$295.84$111.66RVU17C
2017-04-01$295.84$111.66RVU17B
2017-01-01$295.84$111.66RVU17A
2016-10-01$294.43$111.06RVU16D
2016-07-01$294.43$111.06RVU16C
2016-04-01$294.43$111.06RVU16B
2016-01-01$294.43$111.06RVU16A
2015-10-01$294.73$111.76RVU15D
2015-07-01$294.73$111.76RVU15C
2015-04-01$293.26$111.20RVU15B
2015-01-01$293.26$111.20RVU15A
2014-10-01$294.04$110.44RVU14D
2014-07-01$294.04$110.44RVU14C
2014-04-01$294.04$110.44RVU14B
2014-01-01$294.04$110.44RVU14A
2013-10-01$318.17$109.42RVU13D
2013-07-01$318.17$109.42RVU13C
2013-04-01$318.17$109.42RVU13B
2013-01-01$318.17$109.42RVU13AR

Price 49083 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

49083 billing questions

When should 49083 be selected instead of 49082?

Use 49083 when imaging is used to guide the paracentesis. Use 49082 when the paracentesis is performed without imaging guidance.

Can the imaging guidance be reported separately?

Imaging guidance is part of 49083. Do not separately report a guidance service for the same needle placement.

Can modifier 50 be appended for fluid removed from both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.

What documentation supports 49083?

Document the clinical reason for drainage, that peritoneal fluid was removed, and that imaging was used to guide the procedure.

How is 49083 affected when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

Can an assistant or co-surgeon be billed for this procedure?

Medicare does not pay an assistant at surgery for 49083. Co-surgeons and team surgery are not permitted.

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 49083PPRRVU2026_Oct_nonQPP.csv, line 5,771 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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