FeeBase
Log inGet started
Menu

CPT code 49429: Shunt removal, peritoneovenous shunt2026 Medicare rate & RVUs

Removal of an existing peritoneovenous shunt, commonly performed when a shunt used to manage refractory ascites must be taken out.

CMS RVU26DEffective Oct 1, 2026109 payment localities20 Medicare services in 2024

Medicare pays $434.55 for 49429 nationally in a facility.

Medicare rate · 49429

Shunt removal, peritoneovenous shunt

Office or facility?

Work RVUs
7.25
Total RVUs
13.01
Global days
010

National rate · 2026

$434.55

Facility setting, before claim adjustments.

See every locality for 49429 →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 49429 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 49429 covers

This service removes a peritoneovenous shunt that carries fluid from the abdominal cavity into the venous circulation. It may be performed when the device is no longer needed or requires removal; the operative note should identify the shunt and document the removal performed. A surgeon typically carries out the procedure in a hospital operating room or another surgical setting. It is distinct from simply closing off the shunt while leaving it in place.

Report this code for removal, not for shunt insertion, revision, or ligation alone. Documentation should support that the shunt was removed and describe the work performed. Medicare assigns a 10-day global period, including related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this anatomy. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery 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 49429 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

49429 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$390.47
AlaskaUnavailable$534.82
ArizonaUnavailable$421.26
ArkansasUnavailable$385.13
Atlanta, GAUnavailable$450.34
Austin, TXUnavailable$435.04
Bakersfield, CAUnavailable$426.06
Baltimore area, MDUnavailable$463.09
Beaumont, TXUnavailable$418.46
Brazoria, TXUnavailable$421.08

49429 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
49429 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 49429 rate is calculated

Each of 49429’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 · 49429

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.25

7.25 RVUs× 1.000 GPCI

Practice expense3.82

3.82 RVUs× 1.000 GPCI

Malpractice1.94

1.94 RVUs× 1.000 GPCI

Adjusted RVUs

13.0100

Conversion factor

$33.4009

Medicare rate

$434.55

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

Payment rules and modifiers for 49429

49429 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 49429

Shunt removal, peritoneovenous shunt

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 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)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 49429

Shunt removal, peritoneovenous shunt

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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49429 without 51 · national facility

$434.55

Shunt removal, peritoneovenous shunt

49429-51 · Second procedure: 50%

$217.28

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

49429 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 49429

    Shunt removal, peritoneovenous shunt7.25 wRVU

    Not priced

  • 49428

    Shunt ligation, peritoneovenous shunt6.7 wRVU

    Not priced

  • 49426

    Shunt revision, abdominal-to-venous shunt10.15 wRVU

    Not priced

  • 49422

    Catheter removal, tunneled intraperitoneal3.9 wRVU

    Not priced

How to choose

49428Shunt ligationPeritoneovenous shunt
Choose ligation when the shunt is closed off but left in place. Choose 49429 when the shunt itself is removed.
49426Shunt revisionAbdominal-to-venous shunt
This code is for shunt revision; 49429 is for removal rather than repair or alteration of the shunt.
49422Catheter removalTunneled intraperitoneal
This code concerns removal of a tunneled intraperitoneal catheter. Code 49429 concerns removal of a peritoneovenous shunt.

Codes related to 49429

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

Codes related to 49429
CodeHow it relatesNational office range
Same family
49425Abdominal shunt, peritoneal-to-venous drainagePeritoneovenous shunt insertion, rather than removal.No office rate
49426Shunt revision, abdominal-to-venous shuntRevision of an existing peritoneovenous shunt.No office rate
Used instead
49428Shunt ligation, peritoneovenous shuntLigation stops shunt flow while leaving the shunt in place.No office rate
49422Catheter removal, tunneled intraperitonealRemoval of a tunneled intraperitoneal catheter, not a peritoneovenous shunt.No office rate

49429 billing questions

How is shunt removal different from shunt ligation?

Removal takes the shunt out. Ligation stops flow by closing the shunt while leaving it in place.

Can this code be used for revision of a peritoneovenous shunt?

No. Use the revision code when the shunt is revised rather than removed.

Is modifier 50 appropriate if both sides are involved?

No. The anatomy and service do not support bilateral adjustment with modifier 50.

Are related postoperative visits included?

Yes. The 10-day global period includes related postoperative visits during those 10 days.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code, and co-surgeons are not permitted.

What happens when other procedures are performed in the same session?

The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction.

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 49429PPRRVU2026_Oct_nonQPP.csv, line 5,809 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 49429 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 49429 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist