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.
In Washington, DC area, Medicare pays $363.27 for 49321 in a facility. There’s no office rate.
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.
On this page 11 sections
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.
- Washington, DC area · this page$363.27
- Los Angeles, CA · California$342.62−$20.65
- Miami, FL · Florida$398.20+$34.93
- Chicago, IL · Illinois$385.62+$22.35
- Manhattan, NY · New York$383.18+$19.91
- Alaska · Alaska$406.11+$42.84
- Alabama · Alabama$297.29−$65.98
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Merced, CACalifornia | — | $323.40 |
| Modesto, CACalifornia | — | $323.40 |
| Napa, CACalifornia | — | $354.83 |
| Oxnard, CACalifornia | — | $338.48 |
| Redding, CACalifornia | — | $323.40 |
| Rest of CaliforniaCalifornia | — | $323.40 |
| Riverside, CACalifornia | — | $336.91 |
| Sacramento, CACalifornia | — | $334.14 |
| Salinas, CACalifornia | — | $332.82 |
| San Diego, CACalifornia | — | $336.97 |
| Marin County, CACalifornia | — | $368.57 |
| San Francisco, CACalifornia | — | $367.14 |
| San Benito County, CACalifornia | — | $378.00 |
| Santa Clara County, CACalifornia | — | $372.15 |
| San Luis Obispo, CACalifornia | — | $328.14 |
| Santa Cruz, CACalifornia | — | $337.22 |
| Santa Maria, CACalifornia | — | $333.06 |
| Santa Rosa, CACalifornia | — | $340.25 |
| Stockton, CACalifornia | — | $323.40 |
| Vallejo, CACalifornia | — | $352.77 |
| Visalia, CACalifornia | — | $323.40 |
| Yuba City, CACalifornia | — | $323.40 |
| ColoradoColorado | — | $329.29 |
| ConnecticutConnecticut | — | $350.20 |
| DelawareDelaware | — | $324.64 |
| Fort Lauderdale, FLFlorida | — | $364.77 |
| Rest of FloridaFlorida | — | $345.65 |
| Atlanta, GAGeorgia | — | $340.09 |
| Rest of GeorgiaGeorgia | — | $325.51 |
| Hawaii, Guam, HIHawaii | — | $326.72 |
| IowaIowa | — | $294.59 |
| IdahoIdaho | — | $298.34 |
| East St. Louis, ILIllinois | — | $363.19 |
| Rest of IllinoisIllinois | — | $343.44 |
| Suburban Chicago, ILIllinois | — | $366.04 |
| IndianaIndiana | — | $299.65 |
| KansasKansas | — | $297.88 |
| KentuckyKentucky | — | $313.52 |
| New Orleans, LALouisiana | — | $328.55 |
| Rest of LouisianaLouisiana | — | $314.89 |
| Metropolitan Boston, MAMassachusetts | — | $353.34 |
| Rest of MassachusettsMassachusetts | — | $329.46 |
| Baltimore area, MDMaryland | — | $350.19 |
| Rest of MarylandMaryland | — | $328.97 |
| Rest of MaineMaine | — | $304.61 |
| Southern Maine, MEMaine | — | $312.81 |
| Detroit, MIMichigan | — | $354.35 |
| Rest of MichiganMichigan | — | $325.17 |
| MinnesotaMinnesota | — | $302.90 |
| Metropolitan Kansas City, MOMissouri | — | $321.64 |
| Metropolitan St. Louis, MOMissouri | — | $324.13 |
| Rest of MissouriMissouri | — | $313.03 |
| MississippiMississippi | — | $303.03 |
| MontanaMontana | — | $329.25 |
| North CarolinaNorth Carolina | — | $306.76 |
| North DakotaNorth Dakota | — | $304.33 |
| NebraskaNebraska | — | $294.67 |
| New HampshireNew Hampshire | — | $328.59 |
| Northern New JerseyNew Jersey | — | $360.98 |
| Rest of New JerseyNew Jersey | — | $350.64 |
| New MexicoNew Mexico | — | $328.64 |
| NevadaNevada | — | $322.41 |
| NYC suburbs and Long Island, NYNew York | — | $397.56 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $356.61 |
| Queens, NYNew York | — | $379.32 |
| Rest of New YorkNew York | — | $311.32 |
| OhioOhio | — | $320.08 |
| OklahomaOklahoma | — | $308.15 |
| Portland, OROregon | — | $333.63 |
| Rest of OregonOregon | — | $316.39 |
| Metropolitan Philadelphia, PAPennsylvania | — | $345.16 |
| Rest of PennsylvaniaPennsylvania | — | $317.98 |
| Puerto RicoPuerto Rico | — | $329.91 |
| Rhode IslandRhode Island | — | $331.79 |
| South CarolinaSouth Carolina | — | $314.64 |
| South DakotaSouth Dakota | — | $301.39 |
| TennesseeTennessee | — | $299.82 |
| Austin, TXTexas | — | $331.28 |
| Beaumont, TXTexas | — | $316.42 |
| Brazoria, TXTexas | — | $320.50 |
| Dallas, TXTexas | — | $324.51 |
| Fort Worth, TXTexas | — | $323.95 |
| Galveston, TXTexas | — | $322.74 |
| Houston, TXTexas | — | $345.80 |
| Rest of TexasTexas | — | $319.63 |
| UtahUtah | — | $318.43 |
| VirginiaVirginia | — | $315.09 |
| Virgin Islands, VIUnited States Virgin Islands | — | $329.91 |
| VermontVermont | — | $307.44 |
| Rest of WashingtonWashington | — | $327.42 |
| King County, WAWashington | — | $355.50 |
| WisconsinWisconsin | — | $295.58 |
| West VirginiaWest Virginia | — | $333.03 |
| WyomingWyoming | — | $318.39 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.30 | × 1.054 | 5.5862 |
| Practice expense | 3.30 | × 1.178 | 3.8874 |
| Malpractice | 1.26 | × 1.113 | 1.4024 |
| Total RVUs | 10.8760 | ||
| 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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
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%).
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.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $363.27 | RVU26D |
| 2026-07-01 | Not available in this setting | $363.27 | RVU26C |
| 2026-04-01 | Not available in this setting | $363.27 | RVU26B |
| 2026-01-01 | Not available in this setting | $363.27 | RVU26A |
| 2025-10-01 | Not available in this setting | $378.23 | RVU25D |
| 2025-07-01 | Not available in this setting | $378.23 | RVU25C |
| 2025-04-01 | Not available in this setting | $378.23 | RVU25B |
| 2025-01-01 | Not available in this setting | $378.23 | RVU25A |
| 2024-10-01 | Not available in this setting | $386.84 | RVU24D |
| 2024-07-01 | Not available in this setting | $386.84 | RVU24C |
| 2024-04-01 | Not available in this setting | $386.84 | RVU24B |
| 2024-03-09 | Not available in this setting | $386.84 | RVU24AR |
| 2024-01-01 | Not available in this setting | $380.53 | RVU24A |
| 2023-10-01 | Not available in this setting | $395.71 | RVU23D |
| 2023-07-01 | Not available in this setting | $395.71 | RVU23C |
| 2023-04-01 | Not available in this setting | $395.71 | RVU23B |
| 2023-01-01 | Not available in this setting | $395.71 | RVU23A |
| 2022-10-01 | Not available in this setting | $407.00 | RVU22D |
| 2022-07-01 | Not available in this setting | $407.00 | RVU22C |
| 2022-04-01 | Not available in this setting | $407.00 | RVU22B |
| 2022-01-01 | Not available in this setting | $407.00 | RVU22A |
| 2021-10-01 | Not available in this setting | $407.31 | RVU21D |
| 2021-07-01 | Not available in this setting | $407.31 | RVU21C |
| 2021-04-01 | Not available in this setting | $407.31 | RVU21B |
| 2021-01-01 | Not available in this setting | $407.31 | RVU21A |
| 2020-10-01 | Not available in this setting | $410.15 | RVU20D |
| 2020-07-01 | Not available in this setting | $410.15 | RVU20C |
| 2020-04-01 | Not available in this setting | $410.15 | RVU20B |
| 2020-01-01 | Not available in this setting | $410.15 | RVU20A |
| 2019-10-01 | Not available in this setting | $403.92 | RVU19D |
| 2019-07-01 | Not available in this setting | $403.92 | RVU19C |
| 2019-04-01 | Not available in this setting | $403.92 | RVU19B |
| 2019-01-01 | Not available in this setting | $403.92 | RVU19A |
| 2018-10-01 | Not available in this setting | $403.91 | RVU18D |
| 2018-07-01 | Not available in this setting | $403.91 | RVU18C |
| 2018-04-01 | Not available in this setting | $403.91 | RVU18B |
| 2018-01-01 | Not available in this setting | $403.91 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $403.23 | RVU17D |
| 2017-07-01 | Not available in this setting | $403.23 | RVU17C |
| 2017-04-01 | Not available in this setting | $403.23 | RVU17B |
| 2017-01-01 | Not available in this setting | $403.23 | RVU17A |
| 2016-10-01 | Not available in this setting | $404.16 | RVU16D |
| 2016-07-01 | Not available in this setting | $404.16 | RVU16C |
| 2016-04-01 | Not available in this setting | $404.16 | RVU16B |
| 2016-01-01 | Not available in this setting | $404.16 | RVU16A |
| 2015-10-01 | Not available in this setting | $403.37 | RVU15D |
| 2015-07-01 | Not available in this setting | $403.37 | RVU15C |
| 2015-04-01 | Not available in this setting | $401.36 | RVU15B |
| 2015-01-01 | Not available in this setting | $401.36 | RVU15A |
| 2014-10-01 | Not available in this setting | $396.78 | RVU14D |
| 2014-07-01 | Not available in this setting | $396.78 | RVU14C |
| 2014-04-01 | Not available in this setting | $396.78 | RVU14B |
| 2014-01-01 | Not available in this setting | $396.78 | RVU14A |
| 2013-10-01 | Not available in this setting | $390.04 | RVU13D |
| 2013-07-01 | Not available in this setting | $390.04 | RVU13C |
| 2013-04-01 | Not available in this setting | $390.04 | RVU13B |
| 2013-01-01 | Not available in this setting | $390.04 | RVU13AR |
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
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
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