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CPT code 49460: Tube fixation, gastrostomy or cecostomy2026 Medicare rate & RVUs in Queens, NY

Percutaneous fixation secures an existing gastrostomy or cecostomy tube with a device when the tube needs stabilization rather than replacement.

CMS RVU26DEffective Oct 1, 2026One payment locality2.7K Medicare services in 2024

In Queens, NY, Medicare pays $841.02 for 49460 in the office and $47.87 when it’s performed in a hospital or facility.

$841.02Office (non-facility)
$47.87Hospital or facility
+17.8%vs the national office rate ($713.78)

Check a contract rate as a % of Medicare · 49460 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 49460 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 49460 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 49460 covers

This service uses a fixation device to secure an existing gastrostomy or cecostomy tube. It is distinct from placing a new feeding or drainage tube and from exchanging a tube that needs replacement. The procedure may be performed by an interventional radiologist or another physician who manages percutaneous access, typically in a procedural setting, when the tube needs mechanical stabilization.

Report the service when the physician performs the fixation, not merely when staff reinforce an external dressing or check tube position. Documentation should identify the existing tube, the reason fixation is needed, the device used, and the work performed. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is 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 Queens, NY compares for 49460

Across 109 of 109 payment localities, the office rate for 49460 runs from $616.18 in Arkansas to $1,015.21 in San Benito County, CA. Queens, NY pays $841.02. The RVUs are the same everywhere; the geographic indexes change the dollars.

49460 in Queens, NY vs other payment areas
  1. Queens, NY · this page$841.02
  2. Manhattan, NY · New York$828.03−$12.99
  3. NYC suburbs and Long Island, NY · New York$847.43+$6.41
  4. Poughkeepsie and northern NYC suburbs, NY · New York$780.48−$60.54
  5. Rest of New York · New York$678.67−$162.35
  6. Los Angeles, CA · California$837.86−$3.16
  7. Washington, DC area · District of Columbia$836.68−$4.34

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

Every other payment area

49460 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$747.72$49.18
Chicago, ILIllinois$722.58$48.20
AlaskaAlaska$771.77$57.13
AlabamaAlabama$627.24$40.10
ArkansasArkansas$616.18$39.77
ArizonaArizona$692.17$41.95
Bakersfield, CACalifornia$777.93$42.49
Chico, CACalifornia$777.57$42.13

49460 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.

$616.18

$896.39

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

View every state and territory as a table
49460 office rate range by state
State / territoryOffice rate rangeLocalities
AK$771.771
AL$627.241
AR$616.181
AZ$692.171
CA$777.57–$1,015.2129
CO$756.691
CT$767.481
DC$836.681
DE$705.391
FL$685.94–$747.723
GA$641.28–$725.532
GU$805.031
HI$805.031
IA$653.701
ID$657.401
IL$657.02–$735.414
IN$662.201
KS$646.671
KY$638.141
LA$635.60–$674.302
MA$749.42–$846.232
MD$721.90–$836.683
ME$657.99–$706.192
MI$655.28–$692.782
MN$730.631
MO$620.06–$681.223
MS$618.441
MT$713.771
NC$666.881
ND$711.401
NE$659.051
NH$741.091
NJ$777.83–$824.572
NM$658.281
NV$713.791
NY$678.67–$847.435
OH$654.791
OK$640.301
OR$709.87–$788.552
PA$657.93–$742.932
PR$721.181
RI$736.331
SC$661.621
SD$711.121
TN$650.191
TX$652.44–$752.738
UT$672.671
VA$701.07–$836.682
VI$721.181
VT$705.011
WA$749.18–$868.602
WI$682.511
WV$626.641
WY$712.741

See 49460 in every payment locality

How the 49460 rate is calculated

Each of 49460’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 · 49460

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.94

0.94 RVUs× 1.000 GPCI

Practice expense20.31

20.31 RVUs× 1.000 GPCI

Malpractice0.12

0.12 RVUs× 1.000 GPCI

Adjusted RVUs

21.3700

Conversion factor

$33.4009

Medicare rate

$713.78

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

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,819

Code
49460
Physician work
0.94
Practice expense
20.31
Malpractice
0.12

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 49460 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work0.94× 1.0641.0002
Practice expense20.31× 1.18224.0064
Malpractice0.12× 1.4420.1730
Total RVUs25.1796
Conversion factor× 33.4009

Office rate, Queens, NY$841.02

Office: (0.94 × 1.064 + 20.31 × 1.182 + 0.12 × 1.442) × $33.4009 = $841.02

Facility: (0.94 × 1.064 + 0.22 × 1.182 + 0.12 × 1.442) × $33.4009 = $47.87

Open 49460 in the RVU calculator

Payment rules and modifiers for 49460

The CMS indicators that decide how 49460 is paid alongside other services.

CMS payment indicators · 49460

Tube fixation, gastrostomy or cecostomy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49460 without 51 · national office

$713.78

Tube fixation, gastrostomy or cecostomy

49460-51 · Second procedure: 50%

$356.89

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 49460

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

Codes related to 49460
CodeHow it relatesOffice range, Queens, NY
Used instead
49450Feeding tube replacement, gastrostomy or cecostomyUse for replacement of a gastrostomy or cecostomy tube rather than fixation of the existing tube.$662.88
49465Tube examination, fluoroscopic contrast studyEvaluates an existing gastrostomy or cecostomy tube radiographically rather than securing it.$151.73
49440Gastrostomy placement, percutaneous, image-guidedPlaces a new gastrostomy tube rather than fixing an existing one.$920.36
49442Cecostomy tube, percutaneous placementPlaces a new cecostomy tube rather than fixing an existing one.$865.15

How 49460 has changed in Queens, NY

49460 · Office / nonfacility

$841.02

Effective 2026-10-01

The base rate is $46.89 higher than on 2025-10-01, moving from $794.13 to $841.02 (5.9%).

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

    $794.13changed to$841.02

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.96 changed to 0.94
    • Practice expense RVU 19.53 changed to 20.31
    • Malpractice RVU 0.13 changed to 0.12
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $855.02changed to$794.13

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 20.48 changed to 19.53

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $841.07changed to$855.02

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $872.95changed to$841.07

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 20.21 changed to 20.48
    • Malpractice RVU 0.12 changed to 0.13
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $883.67changed to$872.95

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 19.73 changed to 20.21
    • Malpractice RVU 0.11 changed to 0.12
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $934.27changed to$883.67

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 20.74 changed to 19.73

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $910.43changed to$934.27

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 19.73 changed to 20.74
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $882.17changed to$910.43

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 19.38 changed to 19.73
    • Malpractice RVU 0.10 changed to 0.11
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $904.53changed to$882.17

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 19.92 changed to 19.38

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $897.97changed to$904.53

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 19.83 changed to 19.92
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $896.55changed to$897.97

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 19.86 changed to 19.83
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $896.76changed to$896.55

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 19.79 changed to 19.86

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $892.30changed to$896.76

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $893.66changed to$892.30

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 19.84 changed to 19.79
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $916.74changed to$893.66

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 21.57 changed to 19.84
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $916.74

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$841.02$47.87RVU26D
2026-07-01$841.02$47.87RVU26C
2026-04-01$841.02$47.87RVU26B
2026-01-01$841.02$47.87RVU26A
2025-10-01$794.13$55.07RVU25D
2025-07-01$794.13$55.07RVU25C
2025-04-01$794.13$55.07RVU25B
2025-01-01$794.13$55.07RVU25A
2024-10-01$855.02$56.27RVU24D
2024-07-01$855.02$56.27RVU24C
2024-04-01$855.02$56.27RVU24B
2024-03-09$855.02$56.27RVU24AR
2024-01-01$841.07$55.35RVU24A
2023-10-01$872.95$58.50RVU23D
2023-07-01$872.95$58.50RVU23C
2023-04-01$872.95$58.50RVU23B
2023-01-01$872.95$58.50RVU23A
2022-10-01$883.67$60.09RVU22D
2022-07-01$883.67$60.09RVU22C
2022-04-01$883.67$60.09RVU22B
2022-01-01$883.67$60.09RVU22A
2021-10-01$934.27$60.58RVU21D
2021-07-01$934.27$60.58RVU21C
2021-04-01$934.27$60.58RVU21B
2021-01-01$934.27$60.58RVU21A
2020-10-01$910.43$60.91RVU20D
2020-07-01$910.43$60.91RVU20C
2020-04-01$910.43$60.91RVU20B
2020-01-01$910.43$60.91RVU20A
2019-10-01$882.17$58.31RVU19D
2019-07-01$882.17$58.31RVU19C
2019-04-01$882.17$58.31RVU19B
2019-01-01$882.17$58.31RVU19A
2018-10-01$904.53$58.25RVU18D
2018-07-01$904.53$58.25RVU18C
2018-04-01$904.53$58.25RVU18B
2018-01-01$904.53$58.25RVU18AR1
2017-10-01$897.97$58.18RVU17D
2017-07-01$897.97$58.18RVU17C
2017-04-01$897.97$58.18RVU17B
2017-01-01$897.97$58.18RVU17A
2016-10-01$896.55$58.56RVU16D
2016-07-01$896.55$58.56RVU16C
2016-04-01$896.55$58.56RVU16B
2016-01-01$896.55$58.56RVU16A
2015-10-01$896.76$58.78RVU15D
2015-07-01$896.76$58.78RVU15C
2015-04-01$892.30$58.48RVU15B
2015-01-01$892.30$58.48RVU15A
2014-10-01$893.66$57.51RVU14D
2014-07-01$893.66$57.51RVU14C
2014-04-01$893.66$57.51RVU14B
2014-01-01$893.66$57.51RVU14A
2013-10-01$916.74$53.99RVU13D
2013-07-01$916.74$53.99RVU13C
2013-04-01$916.74$53.99RVU13B
2013-01-01$916.74$53.99RVU13AR

Price 49460 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

49460 billing questions

When should 49460 be used instead of 49450?

Use 49460 for fixation of an existing gastrostomy or cecostomy tube with a device. Use 49450 when the service is replacement of a gastrostomy or cecostomy tube.

Does 49460 include the fixation device?

The service is fixation with a device. The record should identify the device and document the fixation work performed.

Can modifier 50 be reported?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.

Is same-day follow-up care separately payable?

No. The 0-day global period includes same-day preoperative and postoperative care.

Can an assistant surgeon be reported?

Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

What happens when another procedure is 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 49460PPRRVU2026_Oct_nonQPP.csv, line 5,819 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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