CPT code 49084: Peritoneal lavage, diagnostic abdominal fluid lavage2026 Medicare rate & RVUs in California
Diagnostic peritoneal lavage evaluates suspected intraperitoneal bleeding or contamination, most often during acute trauma assessment when fluid recovery may guide management.
CMS doesn’t publish an office rate for 49084 in California.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 49084 covers
Peritoneal lavage is a diagnostic abdominal procedure in which the clinician accesses the peritoneal cavity, instills sterile fluid, and retrieves it to assess for blood or other abnormal contents. It is most associated with acute trauma evaluation when intraperitoneal injury remains a concern; a trauma or general surgeon typically performs it in a hospital setting. Imaging guidance, when used, is included in this code.
Report 49084 for the lavage itself, rather than simple removal of ascitic fluid by paracentesis. Documentation should support the clinical concern, the access and lavage performed, and the recovered fluid or findings. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. Medicare 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 49084 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $92.57 |
| Chico, CA | Unavailable | $91.31 |
| El Centro, CA | Unavailable | $91.39 |
| Fresno, CA | Unavailable | $91.31 |
| Hanford, CA | Unavailable | $91.31 |
| Los Angeles, CA | Unavailable | $96.18 |
| Madera, CA | Unavailable | $91.31 |
| Marin County, CA | Unavailable | $100.04 |
| Merced, CA | Unavailable | $91.31 |
| Modesto, CA | Unavailable | $91.31 |
| Napa, CA | Unavailable | $97.29 |
| Oxnard, CA | Unavailable | $94.69 |
| Redding, CA | Unavailable | $91.31 |
| Rest of California | Unavailable | $91.31 |
| Riverside, CA | Unavailable | $96.25 |
| Sacramento, CA | Unavailable | $93.58 |
| Salinas, CA | Unavailable | $93.19 |
| San Benito County, CA | Unavailable | $102.69 |
| San Diego, CA | Unavailable | $93.79 |
| San Francisco, CA | Unavailable | $99.51 |
| San Luis Obispo, CA | Unavailable | $91.97 |
| Santa Clara County, CA | Unavailable | $100.55 |
| Santa Cruz, CA | Unavailable | $93.40 |
| Santa Maria, CA | Unavailable | $93.11 |
| Santa Rosa, CA | Unavailable | $94.19 |
| Stockton, CA | Unavailable | $91.31 |
| Vallejo, CA | Unavailable | $96.54 |
| Visalia, CA | Unavailable | $91.31 |
| Yuba City, CA | Unavailable | $91.31 |
How the 49084 rate is calculated
Each of 49084’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 · 49084
RVUs × geographic indexes × conversion factor
Work1.95
1.95 RVUs× 1.000 GPCI
Practice expense0.46
0.46 RVUs× 1.000 GPCI
Malpractice0.46
0.46 RVUs× 1.000 GPCI
Adjusted RVUs
2.8700
Conversion factor
$33.4009
Medicare rate
$95.86
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49084
The CMS indicators that decide how 49084 is paid alongside other services.
CMS payment indicators · 49084
Peritoneal lavage, diagnostic abdominal fluid lavage
| 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
49084 without 51 · national facility
$95.86
Peritoneal lavage, diagnostic abdominal fluid lavage
49084-51 · Second procedure: 50%
$47.93
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%).
49084 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 49082ParacentesisWithout imaging guidance
- Choose 49082 for abdominal paracentesis without imaging when existing fluid is aspirated. Use 49084 for instillation and retrieval of fluid as a lavage.
- 49083ParacentesisWith imaging guidance
- Choose 49083 for paracentesis performed with imaging guidance. Imaging guidance used during peritoneal lavage is included in 49084.
- 49000Abdominal explorationOpen laparotomy
- 49000 represents open abdominal exploration. 49084 represents peritoneal lavage for fluid assessment, not an open exploration of the abdomen.
49084 billing questions
How is lavage different from paracentesis?
Lavage involves instilling and retrieving fluid to assess the peritoneal cavity, often in trauma evaluation. Paracentesis removes existing abdominal fluid for diagnostic or therapeutic purposes.
Is imaging guidance separately reported with 49084?
No. Imaging guidance, when performed as part of the lavage, is included in this code.
Can modifier 50 be used?
No. The descriptor and anatomy make modifier 50 inappropriate; report the lavage service without bilateral reporting.
How does Medicare handle other procedures in the same session?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. 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
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