CPT code 49321: Laparoscopic biopsy, tissue sampling2026 Medicare rate & RVUs in Washington, DC area

Report this service when a surgeon uses laparoscopy to obtain abdominal or pelvic tissue for examination, rather than aspirating fluid or draining a collection.

CMS RVU26DEffective Oct 1, 2026One payment locality5.1K Medicare services in 2024

In Washington, DC area, Medicare pays $363.27 for 49321 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$363.27Hospital or facility

Check a contract rate as a % of Medicare · 49321 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 49321 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 49321 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 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.

How Washington, DC area compares for 49321

Across 109 of 109 payment localities, the facility rate for 49321 runs from $293.38 in Arkansas to $406.11 in Alaska. Washington, DC area pays $363.27. The RVUs are the same everywhere; the geographic indexes change the dollars.

49321 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$363.27
  2. Los Angeles, CA · California$342.62−$20.65
  3. Miami, FL · Florida$398.20+$34.93
  4. Chicago, IL · Illinois$385.62+$22.35
  5. Manhattan, NY · New York$383.18+$19.91
  6. Alaska · Alaska$406.11+$42.84
  7. Alabama · Alabama$297.29−$65.98

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

49321 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas—$293.38
ArizonaArizona—$319.86
Bakersfield, CACalifornia—$326.82
Chico, CACalifornia—$323.40
El Centro, CACalifornia—$323.61
Fresno, CACalifornia—$323.40
Hanford, CACalifornia—$323.40
Madera, CACalifornia—$323.40

49321 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.

View every state and territory as a table
49321 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 49321 in every payment locality

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.

How the rate is built · 49321

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.30

5.30 RVUs× 1.000 GPCI

Practice expense3.30

3.30 RVUs× 1.000 GPCI

Malpractice1.26

1.26 RVUs× 1.000 GPCI

Adjusted RVUs

9.8600

Conversion factor

$33.4009

Medicare rate

$329.33

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,784

Code
49321
Physician work
5.30
Practice expense
3.30
Malpractice
1.26

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Facility calculation for 49321 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work5.30× 1.0545.5862
Practice expense3.30× 1.1783.8874
Malpractice1.26× 1.1131.4024
Total RVUs10.8760
Conversion factor× 33.4009

Facility rate, Washington, DC area$363.27

Facility: (5.3 × 1.054 + 3.3 × 1.178 + 1.26 × 1.113) × $33.4009 = $363.27

Open 49321 in the RVU calculator

Payment rules and modifiers for 49321

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

CMS payment indicators · 49321

Laparoscopic biopsy, tissue sampling

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 49321

Laparoscopic biopsy, tissue sampling

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49321 without 51 · national facility

$329.33

Laparoscopic biopsy, tissue sampling

49321-51 · Second procedure: 50%

$164.67

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

How 49321 has changed in Washington, DC area

49321 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$363.27RVU26D
2026-07-01Not available in this setting$363.27RVU26C
2026-04-01Not available in this setting$363.27RVU26B
2026-01-01Not available in this setting$363.27RVU26A
2025-10-01Not available in this setting$378.23RVU25D
2025-07-01Not available in this setting$378.23RVU25C
2025-04-01Not available in this setting$378.23RVU25B
2025-01-01Not available in this setting$378.23RVU25A
2024-10-01Not available in this setting$386.84RVU24D
2024-07-01Not available in this setting$386.84RVU24C
2024-04-01Not available in this setting$386.84RVU24B
2024-03-09Not available in this setting$386.84RVU24AR
2024-01-01Not available in this setting$380.53RVU24A
2023-10-01Not available in this setting$395.71RVU23D
2023-07-01Not available in this setting$395.71RVU23C
2023-04-01Not available in this setting$395.71RVU23B
2023-01-01Not available in this setting$395.71RVU23A
2022-10-01Not available in this setting$407.00RVU22D
2022-07-01Not available in this setting$407.00RVU22C
2022-04-01Not available in this setting$407.00RVU22B
2022-01-01Not available in this setting$407.00RVU22A
2021-10-01Not available in this setting$407.31RVU21D
2021-07-01Not available in this setting$407.31RVU21C
2021-04-01Not available in this setting$407.31RVU21B
2021-01-01Not available in this setting$407.31RVU21A
2020-10-01Not available in this setting$410.15RVU20D
2020-07-01Not available in this setting$410.15RVU20C
2020-04-01Not available in this setting$410.15RVU20B
2020-01-01Not available in this setting$410.15RVU20A
2019-10-01Not available in this setting$403.92RVU19D
2019-07-01Not available in this setting$403.92RVU19C
2019-04-01Not available in this setting$403.92RVU19B
2019-01-01Not available in this setting$403.92RVU19A
2018-10-01Not available in this setting$403.91RVU18D
2018-07-01Not available in this setting$403.91RVU18C
2018-04-01Not available in this setting$403.91RVU18B
2018-01-01Not available in this setting$403.91RVU18AR1
2017-10-01Not available in this setting$403.23RVU17D
2017-07-01Not available in this setting$403.23RVU17C
2017-04-01Not available in this setting$403.23RVU17B
2017-01-01Not available in this setting$403.23RVU17A
2016-10-01Not available in this setting$404.16RVU16D
2016-07-01Not available in this setting$404.16RVU16C
2016-04-01Not available in this setting$404.16RVU16B
2016-01-01Not available in this setting$404.16RVU16A
2015-10-01Not available in this setting$403.37RVU15D
2015-07-01Not available in this setting$403.37RVU15C
2015-04-01Not available in this setting$401.36RVU15B
2015-01-01Not available in this setting$401.36RVU15A
2014-10-01Not available in this setting$396.78RVU14D
2014-07-01Not available in this setting$396.78RVU14C
2014-04-01Not available in this setting$396.78RVU14B
2014-01-01Not available in this setting$396.78RVU14A
2013-10-01Not available in this setting$390.04RVU13D
2013-07-01Not available in this setting$390.04RVU13C
2013-04-01Not available in this setting$390.04RVU13B
2013-01-01Not available in this setting$390.04RVU13AR

Price 49321 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

49321 billing questions

When should I report 49321 instead of 49320?

Report 49321 when the surgeon obtains tissue during the laparoscopic procedure. Code 49320 describes diagnostic laparoscopic inspection without the biopsy service.

Can I report the diagnostic laparoscopy separately with the biopsy?

Do not separately report 49320 just for the inspection used to identify or reach the biopsy target. The diagnostic code describes inspection, while 49321 describes laparoscopic tissue sampling.

Is modifier 50 appropriate when biopsies are taken on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy; do not use modifier 50 for bilateral biopsy sites.

How are assistant and co-surgeon services handled?

CMS permits payment for an assistant at surgery and for co-surgeons. Team-surgery payment is not permitted for this code.

What postoperative care is included?

The 10-day global period includes related postoperative visits during the 10 days after the procedure.

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 49321PPRRVU2026_Oct_nonQPP.csv, line 5,784 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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