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CPT code 49402: Foreign body removal, peritoneal cavity, open2026 Medicare rate & RVUs

Reports open surgical removal of a foreign object from the peritoneal cavity, such as a retained item requiring laparotomy.

CMS RVU26DEffective Oct 1, 2026109 payment localities335 Medicare services in 2024

Medicare pays $799.62 for 49402 nationally in a facility.

Medicare rate · 49402

Foreign body removal, peritoneal cavity, open

Office or facility?

Work RVUs
13.74
Total RVUs
23.94
Global days
090

National rate · 2026

$799.62

Facility setting, before claim adjustments.

See every locality for 49402 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 49402 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 49402 covers

This service involves surgically entering the abdomen through a laparotomy to locate and remove a foreign object from the peritoneal cavity. A general surgeon or another surgeon experienced in abdominal operations typically performs it in an operating room. A retained surgical item is a recognizable example; the operative report should identify the object and its intraperitoneal location, and describe its removal through the open approach.

Report the code when the documented service is removal of a foreign body from the peritoneal cavity by laparotomy, rather than removal of a specifically coded catheter or shunt. The record should support the target, location, approach, and work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeon payment requires supporting documentation, and team surgery 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 49402 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

49402 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$722.77
AlaskaUnavailable$994.23
ArizonaUnavailable$776.53
ArkansasUnavailable$713.43
Atlanta, GAUnavailable$826.96
Austin, TXUnavailable$801.22
Bakersfield, CAUnavailable$787.04
Baltimore area, MDUnavailable$850.02
Beaumont, TXUnavailable$771.06
Brazoria, TXUnavailable$776.82

49402 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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
49402 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

How the 49402 rate is calculated

Each of 49402’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 · 49402

RVUs × geographic indexes × conversion factor

Office or facility?

Work13.74

13.74 RVUs× 1.000 GPCI

Practice expense6.88

6.88 RVUs× 1.000 GPCI

Malpractice3.32

3.32 RVUs× 1.000 GPCI

Adjusted RVUs

23.9400

Conversion factor

$33.4009

Medicare rate

$799.62

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

Payment rules and modifiers for 49402

49402 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 49402

Foreign body removal, peritoneal cavity, open

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 49402

Foreign body removal, peritoneal cavity, open

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49402 without 51 · national facility

$799.62

Foreign body removal, peritoneal cavity, open

49402-51 · Second procedure: 50%

$399.81

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

49402 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 49402

    Foreign body removal, peritoneal cavity, open13.74 wRVU

    Not priced

  • 49000

    Abdominal exploration, open laparotomy12.23 wRVU

    Not priced

  • 49002

    Abdominal reoperation, recent laparotomy17.19 wRVU

    Not priced

  • 49422

    Catheter removal, tunneled intraperitoneal3.9 wRVU

    Not priced

  • 49429

    Shunt removal, peritoneovenous shunt7.25 wRVU

    Not priced

How to choose

49000Abdominal explorationOpen laparotomy
49000 is an exploratory laparotomy. Report 49402 when the documented operation includes removal of a foreign body from the peritoneal cavity.
49002Abdominal reoperationRecent laparotomy
49002 describes reopening a recent laparotomy. It is not the foreign-body removal service described by 49402.
49422Catheter removalTunneled intraperitoneal
49422 is for removing a tunneled intraperitoneal catheter. Use 49402 for a different foreign object removed from the peritoneal cavity by laparotomy.
49429Shunt removalPeritoneovenous shunt
49429 is specifically for removal of a peritoneovenous shunt; 49402 concerns other foreign bodies removed from the peritoneal cavity.

Codes related to 49402

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

Codes related to 49402
CodeHow it relatesNational office range
Used instead
49422Catheter removal, tunneled intraperitonealUse for removal of a tunneled intraperitoneal catheter rather than a general foreign body.No office rate
49429Shunt removal, peritoneovenous shuntUse for removal of a peritoneovenous shunt, not a nonspecific intraperitoneal foreign object.No office rate
49002Abdominal reoperation, recent laparotomyDescribes reopening a recent laparotomy when that is the service performed, rather than foreign-body removal.No office rate

49402 billing questions

When should 49402 be chosen instead of a catheter-removal code?

Use 49402 for open removal of a foreign body from the peritoneal cavity. A tunneled intraperitoneal catheter or a peritoneovenous shunt has a specific removal code, such as 49422 or 49429.

Does the code include the laparotomy?

The service is removal through a laparotomy. The operative documentation should show the open approach and removal; do not treat the laparotomy as a separate exploratory service solely because the abdomen was entered.

What documentation supports reporting 49402?

Document the foreign object, its location in the peritoneal cavity, the laparotomy approach, and the removal performed. A record describing only abdominal exploration without removal does not establish this service.

How does Medicare handle other procedures performed in the same session?

The highest-valued procedure is paid in full, and other procedures are paid at 50%. Modifier 50 is inappropriate for 49402.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this service. Co-surgeons are paid only when supporting documentation is provided; team surgery is 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 49402PPRRVU2026_Oct_nonQPP.csv, line 5,793 (RVU26D)

Open CMS sourceHow we calculate rates

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