CPT code 49422: Catheter removal, tunneled intraperitoneal2026 Medicare rate & RVUs in Maryland
Removal of a tunneled catheter from the peritoneal cavity, commonly for peritoneal dialysis patients with infection, malfunction, or no further need for access.
CMS doesn’t publish an office rate for 49422 in Maryland.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $214.30 |
| Rest of Maryland | Unavailable | $200.89 |
| Washington, DC area | Unavailable | $219.41 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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%).
49422 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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