CPT code 49321: Laparoscopic biopsy, tissue sampling2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 49321 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.

What 49321 covers

The surgeon uses a laparoscope and operative instruments to remove one or more tissue samples from an abdominal or pelvic site for histologic evaluation. Common targets include a peritoneal or omental lesion or an accessible abdominal mass. The procedure is generally performed in a hospital or ambulatory surgery facility by a general surgeon or another surgeon treating the suspected disease; a gynecologic surgeon may perform it when the target is in the pelvis.

Choose this code when tissue is obtained, not when the laparoscopic service only inspects the cavity, aspirates fluid, or drains a collection. The operative report should identify the biopsy site and document tissue removal; the pathology service is separately identified when performed and billed. CMS assigns a 10-day global period, including related postoperative visits during that period. Endoscopy-family pricing applies when related endoscopies are performed together. Modifier 50 is inappropriate for this descriptor and anatomy. CMS permits assistant-at-surgery and co-surgeon payment; team-surgery payment is 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 49321 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

How the 49321 rate is calculated

Each of 49321’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.

Payment rules and modifiers for 49321

49321 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

49321 compared with similar codes

How to choose

49320Diagnostic laparoscopyAbdomen and peritoneum

Use 49320 for diagnostic laparoscopic inspection when no biopsy is performed. When the surgeon obtains tissue, 49321 describes the biopsy service.

49322Laparoscopic aspirationCyst or cavity

Use 49322 for laparoscopic aspiration, such as removing fluid from a cyst or cavity. Use 49321 when the surgeon removes tissue for histologic evaluation.

49323Lymphocele drainageLaparoscopic approach

49323 describes laparoscopic drainage of a lymphocele; 49321 is for obtaining tissue samples, not draining the collection.

Codes related to 49321

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

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

Open CMS sourceHow we calculate rates