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CPT code 49441: Enteral tube placement, duodenal or jejunal tube2026 Medicare rate & RVUs in Delaware

Reports image-guided percutaneous placement of an enteral tube into the duodenum or jejunum when postpyloric feeding access is needed.

CMS RVU26DEffective Oct 1, 2026One payment locality410 Medicare services in 2024

In Delaware, Medicare pays $970.27 for 49441 in the office and $215.22 when it’s performed in a hospital or facility.

$970.27Office (non-facility)
$215.22Hospital or facility
−1.2%vs the national office rate ($981.65)

Check a contract rate as a % of Medicare · 49441 nationwide

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

We’ll open 49441 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 49441 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Delaware compares for 49441

Across 109 of 109 payment localities, the office rate for 49441 runs from $855.85 in Arkansas to $1,345.15 in San Benito County, CA. Delaware pays $970.27. The RVUs are the same everywhere; the geographic indexes change the dollars.

49441 in Delaware vs other payment areas
  1. Delaware · this page$970.27
  2. Los Angeles, CA · California$1,128.07+$157.80
  3. Washington, DC area · District of Columbia$1,136.58+$166.31
  4. Miami, FL · Florida$1,051.15+$80.88
  5. Chicago, IL · Illinois$1,017.45+$47.18
  6. Manhattan, NY · New York$1,136.30+$166.03
  7. Alaska · Alaska$1,097.35+$127.08

Other areas in Delaware first, then benchmark localities. Bars start at $0.

Every other payment area

49441 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$870.03$201.34
ArkansasArkansas$855.85$199.39
ArizonaArizona$953.11$212.59
Bakersfield, CACalifornia$1,053.00$215.42
Chico, CACalifornia$1,050.97$213.40
El Centro, CACalifornia$1,051.09$213.52
Fresno, CACalifornia$1,050.97$213.40
Hanford, CACalifornia$1,050.97$213.40

49441 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.

$855.85

$1,198.06

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
49441 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,097.351
AL$870.031
AR$855.851
AZ$953.111
CA$1,050.97–$1,345.1529
CO$1,030.111
CT$1,052.001
DC$1,136.581
DE$970.271
FL$957.91–$1,051.153
GA$898.66–$999.832
GU$1,082.731
HI$1,082.731
IA$898.451
ID$904.301
IL$924.48–$1,022.884
IN$910.291
KS$892.071
KY$889.661
LA$887.43–$937.052
MA$1,022.16–$1,142.352
MD$990.91–$1,136.583
ME$907.84–$965.612
MI$914.19–$969.552
MN$988.471
MO$869.17–$942.793
MS$862.781
MT$981.611
NC$918.781
ND$967.571
NE$904.481
NH$1,011.921
NJ$1,064.42–$1,122.252
NM$919.141
NV$978.501
NY$934.08–$1,164.615
OH$911.321
OK$889.631
OR$971.37–$1,067.922
PA$913.88–$1,022.122
PR$990.211
RI$1,008.641
SC$916.491
SD$965.911
TN$896.901
TX$907.01–$1,026.268
UT$930.601
VA$960.90–$1,136.582
VI$990.211
VT$961.831
WA$1,020.86–$1,168.692
WI$931.201
WV$885.681
WY$975.491

See 49441 in every payment locality

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

Office or facility?

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.

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,813

Code
49441
Physician work
4.41
Practice expense
24.27
Malpractice
0.71

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 49441 in Delaware
ComponentRVULocality factorAdjusted
Physician work4.41× 1.0054.4320
Practice expense24.27× 0.98823.9788
Malpractice0.71× 0.8990.6383
Total RVUs29.0491
Conversion factor× 33.4009

Office rate, Delaware$970.27

Office: (4.41 × 1.005 + 24.27 × 0.988 + 0.71 × 0.899) × $33.4009 = $970.27

Facility: (4.41 × 1.005 + 1.39 × 0.988 + 0.71 × 0.899) × $33.4009 = $215.22

Open 49441 in the RVU calculator

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

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)0Not paid without supporting documentation.
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 · 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

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%).

When to use modifier 51

Codes related to 49441

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

Codes related to 49441
CodeHow it relatesOffice range, Delaware
Same family
49440Gastrostomy placement, percutaneous, image-guidedPercutaneous placement into the stomach rather than the duodenum or jejunum.$779.70
49442Cecostomy tube, percutaneous placementPercutaneous tube placement into the cecum, a different enteral access site.$733.61
49451Feeding tube exchange, duodenal or jejunal tubePercutaneous replacement of an existing duodenal or jejunal tube.$595.05
Used instead
49446Tube conversion, G-tube to G-J tubeConverts an existing gastrostomy tube to a gastrojejunostomy tube.$755.03

How 49441 has changed in Delaware

49441 · Office / nonfacility

$970.27

Effective 2026-10-01

The base rate is $75.70 higher than on 2025-10-01, moving from $894.57 to $970.27 (8.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $894.57changed to$970.27

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.52 changed to 4.41
    • Practice expense RVU 22.65 changed to 24.27
    • Malpractice RVU 0.66 changed to 0.71
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $937.13changed to$894.57

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 23.17 changed to 22.65
    • Malpractice RVU 0.64 changed to 0.66

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $921.84changed to$937.13

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $975.94changed to$921.84

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 23.53 changed to 23.17
    • Malpractice RVU 0.59 changed to 0.64
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $1025.37changed to$975.94

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 24.03 changed to 23.53
    • Malpractice RVU 0.57 changed to 0.59
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1096.73changed to$1025.37

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 25.82 changed to 24.03
    • Malpractice RVU 0.54 changed to 0.57

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1110.02changed to$1096.73

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 25.11 changed to 25.82
    • Malpractice RVU 0.56 changed to 0.54
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1124.88changed to$1110.02

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 25.56 changed to 25.11
    • Malpractice RVU 0.55 changed to 0.56
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1141.22changed to$1124.88

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 26.05 changed to 25.56
    • Malpractice RVU 0.54 changed to 0.55

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $1141.64changed to$1141.22

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 25.99 changed to 26.05
    • Malpractice RVU 0.55 changed to 0.54
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1230.81changed to$1141.64

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 4.77 changed to 4.52
    • Practice expense RVU 28.03 changed to 25.99
    • Malpractice RVU 0.60 changed to 0.55
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1225.65changed to$1230.81

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 27.75 changed to 28.03
    • Malpractice RVU 0.62 changed to 0.60

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $1219.56changed to$1225.65

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1236.38changed to$1219.56

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 28.16 changed to 27.75
    • Malpractice RVU 0.52 changed to 0.62
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $1267.76changed to$1236.38

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 30.72 changed to 28.16
    • Malpractice RVU 0.54 changed to 0.52
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $1267.76

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$970.27$215.22RVU26D
2026-07-01$970.27$215.22RVU26C
2026-04-01$970.27$215.22RVU26B
2026-01-01$970.27$215.22RVU26A
2025-10-01$894.57$231.32RVU25D
2025-07-01$894.57$231.32RVU25C
2025-04-01$894.57$231.32RVU25B
2025-01-01$894.57$231.32RVU25A
2024-10-01$937.13$235.10RVU24D
2024-07-01$937.13$235.10RVU24C
2024-04-01$937.13$235.10RVU24B
2024-03-09$937.13$235.10RVU24AR
2024-01-01$921.84$231.26RVU24A
2023-10-01$975.94$237.83RVU23D
2023-07-01$975.94$237.83RVU23C
2023-04-01$975.94$237.83RVU23B
2023-01-01$975.94$237.83RVU23A
2022-10-01$1,025.37$241.27RVU22D
2022-07-01$1,025.37$241.27RVU22C
2022-04-01$1,025.37$241.27RVU22B
2022-01-01$1,025.37$241.27RVU22A
2021-10-01$1,096.73$243.01RVU21D
2021-07-01$1,096.73$243.01RVU21C
2021-04-01$1,096.73$243.01RVU21B
2021-01-01$1,096.73$243.01RVU21A
2020-10-01$1,110.02$255.16RVU20D
2020-07-01$1,110.02$255.16RVU20C
2020-04-01$1,110.02$255.16RVU20B
2020-01-01$1,110.02$255.16RVU20A
2019-10-01$1,124.88$257.09RVU19D
2019-07-01$1,124.88$257.09RVU19C
2019-04-01$1,124.88$257.09RVU19B
2019-01-01$1,124.88$257.09RVU19A
2018-10-01$1,141.22$257.14RVU18D
2018-07-01$1,141.22$257.14RVU18C
2018-04-01$1,141.22$257.14RVU18B
2018-01-01$1,141.22$257.14RVU18AR1
2017-10-01$1,141.64$258.04RVU17D
2017-07-01$1,141.64$258.04RVU17C
2017-04-01$1,141.64$258.04RVU17B
2017-01-01$1,141.64$258.04RVU17A
2016-10-01$1,230.81$272.88RVU16D
2016-07-01$1,230.81$272.88RVU16C
2016-04-01$1,230.81$272.88RVU16B
2016-01-01$1,230.81$272.88RVU16A
2015-10-01$1,225.65$274.65RVU15D
2015-07-01$1,225.65$274.65RVU15C
2015-04-01$1,219.56$273.28RVU15B
2015-01-01$1,219.56$273.28RVU15A
2014-10-01$1,236.38$267.37RVU14D
2014-07-01$1,236.38$267.37RVU14C
2014-04-01$1,236.38$267.37RVU14B
2014-01-01$1,236.38$267.37RVU14A
2013-10-01$1,267.76$256.15RVU13D
2013-07-01$1,267.76$256.15RVU13C
2013-04-01$1,267.76$256.15RVU13B
2013-01-01$1,267.76$256.15RVU13AR

Price 49441 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

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
RVUs for 49441PPRRVU2026_Oct_nonQPP.csv, line 5,813 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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