CPT code 49425: Abdominal shunt, peritoneal-to-venous drainage2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $823.16 for 49425 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 49425 nationwide

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

What 49425 covers

This service places a shunt connecting the peritoneal cavity with the venous system, allowing ascitic fluid to flow into the circulation. It is generally performed by a surgeon in a hospital operating room for a patient with ascites when peritoneovenous diversion is selected. The operative record should identify the indication and document creation of the abdominal-to-venous shunt pathway and its placement.

Report 49425 for the shunt insertion itself, not for later revision, evaluation, ligation, or removal. Documentation should distinguish new placement from work on an existing shunt. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. An assistant at surgery may be paid; 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.

How Washington, DC area compares for 49425

Across 109 of 109 payment localities, the facility rate for 49425 runs from $660.80 in Arkansas to $918.85 in Miami, FL. Washington, DC area pays $823.16. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

49425 rates by state

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

See 49425 in every payment locality

How the 49425 rate is calculated

Each of 49425’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.

Payment rules and modifiers for 49425

49425 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 49425

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

How 49425 has changed in Washington, DC area

Price 49425 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

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

Open CMS sourceHow we calculate rates