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CPT code 49422: Catheter removal, tunneled intraperitoneal2026 Medicare rate & RVUs

Removal of a tunneled catheter from the peritoneal cavity, commonly for peritoneal dialysis patients with infection, malfunction, or no further need for access.

CMS RVU26DEffective Oct 1, 2026109 payment localities9.5K Medicare services in 2024

Medicare pays $201.74 for 49422 nationally in a facility.

Medicare rate · 49422

Catheter removal, tunneled intraperitoneal

Office or facility?

Work RVUs
3.9
Total RVUs
6.04
Global days
000

National rate · 2026

$201.74

Facility setting, before claim adjustments.

See every locality for 49422 →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 49422 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 49422 covers

This code covers removal of a tunneled catheter that enters the peritoneal cavity, including a peritoneal dialysis catheter. A surgeon or other qualified physician may perform the procedure in an operating room or another procedural setting, such as when catheter-related infection or malfunction requires removal, or when the patient no longer needs peritoneal access. The service is removal of the existing catheter, not placement of a replacement device.

Report the code when the tunneled intraperitoneal catheter is actually removed. The operative note should identify the catheter and document its removal; include the clinical reason when available. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment is statutorily restricted, and co-surgeon and team-surgery payment 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 49422 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

49422 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$182.90
AlaskaUnavailable$255.04
ArizonaUnavailable$195.90
ArkansasUnavailable$180.63
Atlanta, GAUnavailable$209.21
Austin, TXUnavailable$200.63
Bakersfield, CAUnavailable$195.46
Baltimore area, MDUnavailable$214.30
Beaumont, TXUnavailable$195.92
Brazoria, TXUnavailable$195.37

49422 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
49422 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 49422 rate is calculated

Each of 49422’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 · 49422

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.90

3.90 RVUs× 1.000 GPCI

Practice expense1.18

1.18 RVUs× 1.000 GPCI

Malpractice0.96

0.96 RVUs× 1.000 GPCI

Adjusted RVUs

6.0400

Conversion factor

$33.4009

Medicare rate

$201.74

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

Payment rules and modifiers for 49422

The CMS indicators that decide how 49422 is paid alongside other services.

CMS payment indicators · 49422

Catheter removal, tunneled intraperitoneal

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49422 without 51 · national facility

$201.74

Catheter removal, tunneled intraperitoneal

49422-51 · Second procedure: 50%

$100.87

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

49422 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 49422

    Catheter removal, tunneled intraperitoneal3.9 wRVU

    Not priced

  • 49421

    Dialysis catheter placement, open, tunneled peritoneal access4.1 wRVU

    Not priced

  • 49418

    Peritoneal catheter, percutaneous tunneled placement3.86 wRVU

    $939.57

  • 49423

    Drain catheter exchange, fluoroscopic exchange1.42 wRVU

    $549.44

  • 49402

    Foreign body removal, peritoneal cavity, open13.74 wRVU

    Not priced

How to choose

49421Dialysis catheter placementOpen, tunneled peritoneal access
Use 49422 for removal of an existing catheter; 49421 describes open placement of a tunneled intraperitoneal catheter for dialysis.
49418Peritoneal catheterPercutaneous tunneled placement
49418 describes percutaneous placement of a tunneled intraperitoneal catheter, not removal of one already in place.
49423Drain catheter exchangeFluoroscopic exchange
49423 describes exchange of a drainage catheter. 49422 is specific to removal of a tunneled intraperitoneal catheter.
49402Foreign body removalPeritoneal cavity, open
49402 concerns removal of a foreign body from the abdomen; 49422 is for removal of a tunneled intraperitoneal catheter.

Codes related to 49422

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

Codes related to 49422
CodeHow it relatesNational office range
Often billed with
49421Dialysis catheter placement, open, tunneled peritoneal accessMay be reported when open placement of a replacement dialysis catheter accompanies removal in the same session.No office rate
49418Peritoneal catheter, percutaneous tunneled placementDescribes percutaneous tunneled intraperitoneal catheter placement when a replacement is placed during the session.$820.21–$1,298.74
49419Peritoneal catheter, with subcutaneous portDescribes placement of a tunneled intraperitoneal catheter with a subcutaneous port.No office rate

49422 billing questions

How does 49422 differ from 49421?

49422 is for removing an existing tunneled intraperitoneal catheter. 49421 describes open placement of a tunneled intraperitoneal catheter for dialysis.

Can catheter insertion be reported during the same session?

When a new catheter is placed during the same session as removal, the insertion service may be reported separately when performed and documented. For example, 49421 describes open placement for dialysis.

Should modifier 50 be used for removal of two catheters?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 does not describe the service.

What global period applies?

The procedure has a 0-day global period. Same-day preoperative and postoperative care is included.

Can an assistant or co-surgeon be paid for this procedure?

Assistant-at-surgery payment is subject to a statutory restriction. CMS also identifies co-surgeon and team-surgery payment as 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 49422PPRRVU2026_Oct_nonQPP.csv, line 5,802 (RVU26D)

Open CMS sourceHow we calculate rates

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