CPT code 49441: Enteral tube placement, duodenal or jejunal tube2026 Medicare rate & RVUs
Reports image-guided percutaneous placement of an enteral tube into the duodenum or jejunum when postpyloric feeding access is needed.
Medicare pays $981.65 for 49441 nationally in the office and $217.44 in a hospital or facility. Local office rates run $855.85–$1,345.15.
Medicare rate · 49441
Enteral tube placement, duodenal or jejunal tube
- Work RVUs
- 4.41
- Total RVUs
- 29.39
- Global days
- 010
National rate · 2026
$981.65
Office setting, before claim adjustments.
See every locality for 49441 →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.
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On this page 10 sections
What 49441 covers
This service establishes enteral access to the duodenum or jejunum through a percutaneous approach, using fluoroscopic guidance to position the tube and confirm its location. It is typically performed by an interventional radiologist in a hospital setting when a patient needs small-bowel feeding access rather than feeding into the stomach. Fluoroscopic guidance, contrast injections, and the related radiological supervision and interpretation are part of the placement service.
Report 49441 for new percutaneous duodenal or jejunal tube placement, not for exchanging an existing tube or converting a gastrostomy tube to a gastrojejunostomy tube. The procedure report should support the access site, tube destination, placement technique, and imaging confirmation. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 49441 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$855.85 to $1345.15
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $870.03 | $201.34 |
| Alaska | $1,097.35 | $283.46 |
| Arizona | $953.11 | $212.59 |
| Arkansas | $855.85 | $199.39 |
| Atlanta, GA | $999.83 | $223.39 |
| Austin, TX | $1,026.26 | $217.72 |
| Bakersfield, CA | $1,053.00 | $215.42 |
| Baltimore area, MD | $1,048.81 | $228.81 |
| Beaumont, TX | $907.01 | $211.58 |
| Brazoria, TX | $970.32 | $212.98 |
| Chicago, IL | $1,017.45 | $249.41 |
| Chico, CA | $1,050.97 | $213.40 |
| Colorado | $1,030.11 | $216.99 |
| Connecticut | $1,052.00 | $228.94 |
| Dallas, TX | $976.37 | $215.21 |
| Delaware | $970.27 | $215.22 |
| Detroit, MI | $969.55 | $232.08 |
| East St. Louis, IL | $940.85 | $237.77 |
| El Centro, CA | $1,051.09 | $213.52 |
| Fort Lauderdale, FL | $1,011.35 | $237.20 |
| Fort Worth, TX | $968.57 | $215.06 |
| Fresno, CA | $1,050.97 | $213.40 |
| Galveston, TX | $973.08 | $214.21 |
| Hanford, CA | $1,050.97 | $213.40 |
| Hawaii, Guam, HI | $1,082.73 | $213.82 |
| Houston, TX | $986.07 | $227.21 |
| Idaho | $904.30 | $201.23 |
| Indiana | $910.29 | $201.86 |
| Iowa | $898.45 | $199.19 |
| Kansas | $892.07 | $201.22 |
| Kentucky | $889.66 | $210.27 |
| King County, WA | $1,168.69 | $231.00 |
| Los Angeles, CA | $1,128.07 | $224.01 |
| Madera, CA | $1,050.97 | $213.40 |
| Manhattan, NY | $1,136.30 | $248.28 |
| Marin County, CA | $1,315.18 | $237.64 |
| Merced, CA | $1,050.97 | $213.40 |
| Metropolitan Boston, MA | $1,142.35 | $229.88 |
| Metropolitan Kansas City, MO | $931.66 | $214.06 |
| Metropolitan Philadelphia, PA | $1,022.12 | $226.57 |
| Metropolitan St. Louis, MO | $942.79 | $215.26 |
| Miami, FL | $1,051.15 | $255.60 |
| Minnesota | $988.47 | $202.09 |
| Mississippi | $862.78 | $204.80 |
| Modesto, CA | $1,050.97 | $213.40 |
| Montana | $981.61 | $217.39 |
| Napa, CA | $1,237.05 | $229.82 |
| Nebraska | $904.48 | $199.11 |
| Nevada | $978.50 | $213.53 |
| New Hampshire | $1,011.92 | $216.38 |
| New Mexico | $919.14 | $218.35 |
| New Orleans, LA | $937.05 | $217.93 |
| North Carolina | $918.78 | $205.77 |
| North Dakota | $967.57 | $203.35 |
| Northern New Jersey | $1,122.25 | $235.76 |
| NYC suburbs and Long Island, NY | $1,164.61 | $255.97 |
| Ohio | $911.32 | $213.59 |
| Oklahoma | $889.63 | $207.18 |
| Oxnard, CA | $1,124.37 | $221.07 |
| Portland, OR | $1,067.92 | $218.88 |
| Poughkeepsie and northern NYC suburbs, NY | $1,070.27 | $233.46 |
| Puerto Rico | $990.21 | $217.59 |
| Queens, NY | $1,149.10 | $245.80 |
| Redding, CA | $1,050.97 | $213.40 |
| Rest of California | $1,050.97 | $213.40 |
| Rest of Florida | $957.91 | $227.33 |
| Rest of Georgia | $898.66 | $216.98 |
| Rest of Illinois | $924.48 | $226.75 |
| Rest of Louisiana | $887.43 | $211.10 |
| Rest of Maine | $907.84 | $204.76 |
| Rest of Maryland | $990.91 | $217.53 |
| Rest of Massachusetts | $1,022.16 | $217.44 |
| Rest of Michigan | $914.19 | $216.46 |
| Rest of Missouri | $869.17 | $210.42 |
| Rest of New Jersey | $1,064.42 | $229.90 |
| Rest of New York | $934.08 | $208.08 |
| Rest of Oregon | $971.37 | $210.21 |
| Rest of Pennsylvania | $913.88 | $212.33 |
| Rest of Texas | $938.01 | $212.77 |
| Rest of Washington | $1,020.86 | $216.15 |
| Rhode Island | $1,008.64 | $219.21 |
| Riverside, CA | $1,058.64 | $221.06 |
| Sacramento, CA | $1,108.09 | $219.31 |
| Salinas, CA | $1,104.11 | $218.38 |
| San Benito County, CA | $1,345.15 | $243.16 |
| San Diego, CA | $1,134.10 | $220.10 |
| San Francisco, CA | $1,314.37 | $236.83 |
| San Luis Obispo, CA | $1,085.83 | $215.39 |
| Santa Clara County, CA | $1,341.86 | $239.86 |
| Santa Cruz, CA | $1,148.03 | $219.51 |
| Santa Maria, CA | $1,109.34 | $218.27 |
| Santa Rosa, CA | $1,159.89 | $221.44 |
| South Carolina | $916.49 | $210.35 |
| South Dakota | $965.91 | $201.69 |
| Southern Maine, ME | $965.61 | $208.27 |
| Stockton, CA | $1,050.97 | $213.40 |
| Suburban Chicago, IL | $1,022.88 | $238.03 |
| Tennessee | $896.90 | $202.24 |
| Utah | $930.60 | $212.24 |
| Vallejo, CA | $1,235.89 | $228.65 |
| Vermont | $961.83 | $205.26 |
| Virgin Islands, VI | $990.21 | $217.59 |
| Virginia | $960.90 | $209.68 |
| Visalia, CA | $1,050.97 | $213.40 |
| Washington, DC area | $1,136.58 | $236.34 |
| West Virginia | $885.68 | $221.58 |
| Wisconsin | $931.20 | $199.08 |
| Wyoming | $975.49 | $211.27 |
| Yuba City, CA | $1,050.97 | $213.40 |
49441 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$855.85
$1,198.06
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $1,097.35 | 1 |
| AL | $870.03 | 1 |
| AR | $855.85 | 1 |
| AZ | $953.11 | 1 |
| CA | $1,050.97–$1,345.15 | 29 |
| CO | $1,030.11 | 1 |
| CT | $1,052.00 | 1 |
| DC | $1,136.58 | 1 |
| DE | $970.27 | 1 |
| FL | $957.91–$1,051.15 | 3 |
| GA | $898.66–$999.83 | 2 |
| GU | $1,082.73 | 1 |
| HI | $1,082.73 | 1 |
| IA | $898.45 | 1 |
| ID | $904.30 | 1 |
| IL | $924.48–$1,022.88 | 4 |
| IN | $910.29 | 1 |
| KS | $892.07 | 1 |
| KY | $889.66 | 1 |
| LA | $887.43–$937.05 | 2 |
| MA | $1,022.16–$1,142.35 | 2 |
| MD | $990.91–$1,136.58 | 3 |
| ME | $907.84–$965.61 | 2 |
| MI | $914.19–$969.55 | 2 |
| MN | $988.47 | 1 |
| MO | $869.17–$942.79 | 3 |
| MS | $862.78 | 1 |
| MT | $981.61 | 1 |
| NC | $918.78 | 1 |
| ND | $967.57 | 1 |
| NE | $904.48 | 1 |
| NH | $1,011.92 | 1 |
| NJ | $1,064.42–$1,122.25 | 2 |
| NM | $919.14 | 1 |
| NV | $978.50 | 1 |
| NY | $934.08–$1,164.61 | 5 |
| OH | $911.32 | 1 |
| OK | $889.63 | 1 |
| OR | $971.37–$1,067.92 | 2 |
| PA | $913.88–$1,022.12 | 2 |
| PR | $990.21 | 1 |
| RI | $1,008.64 | 1 |
| SC | $916.49 | 1 |
| SD | $965.91 | 1 |
| TN | $896.90 | 1 |
| TX | $907.01–$1,026.26 | 8 |
| UT | $930.60 | 1 |
| VA | $960.90–$1,136.58 | 2 |
| VI | $990.21 | 1 |
| VT | $961.83 | 1 |
| WA | $1,020.86–$1,168.69 | 2 |
| WI | $931.20 | 1 |
| WV | $885.68 | 1 |
| WY | $975.49 | 1 |
How the 49441 rate is calculated
Each of 49441’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 · 49441
RVUs × geographic indexes × conversion factor
Work4.41
4.41 RVUs× 1.000 GPCI
Practice expense24.27
24.27 RVUs× 1.000 GPCI
Malpractice0.71
0.71 RVUs× 1.000 GPCI
Adjusted RVUs
29.3900
Conversion factor
$33.4009
Medicare rate
$981.65
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49441
49441 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49441
Enteral tube placement, duodenal or jejunal tube
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 49441
Enteral tube placement, duodenal or jejunal tube
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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49441 without 51 · national office
$981.65
Enteral tube placement, duodenal or jejunal tube
49441-51 · Second procedure: 50%
$490.83
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%).
49441 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 49440Gastrostomy placementPercutaneous, image-guided
- Choose 49440 for new percutaneous tube placement into the stomach. Choose 49441 when the tube is placed into the duodenum or jejunum.
- 49442Cecostomy tubePercutaneous placement
- 49442 places a tube into the cecum; 49441 places enteral access into the duodenum or jejunum.
- 49446Tube conversionG-tube to G-J tube
- 49446 converts an existing gastrostomy tube to a gastrojejunostomy tube. 49441 reports new percutaneous duodenal or jejunal tube placement.
- 49451Feeding tube exchangeDuodenal or jejunal tube
- 49451 is for percutaneous replacement of an existing duodenal or jejunal tube. Use 49441 for new placement.
49441 billing questions
How does 49441 differ from 49440?
49441 establishes percutaneous tube access to the duodenum or jejunum. Use 49440 when the tube is placed into the stomach.
Can fluoroscopic guidance and contrast be billed separately?
The placement service includes fluoroscopic guidance, contrast injections, and the related radiological supervision and interpretation.
Is 49441 used to replace an existing duodenal or jejunal tube?
No. Report 49441 for new placement; 49451 describes percutaneous replacement of a duodenal or jejunal tube.
What postoperative care is included?
Related postoperative visits for 10 days are included in the global period.
Can modifier 50 be used, or can an assistant surgeon be paid?
Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are 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
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