CPT code 49465: Tube examination, fluoroscopic contrast study2026 Medicare rate & RVUs in Connecticut

Fluoroscopic contrast evaluation checks the position and function of an indwelling gastric, intestinal, or colostomy tube when a tube problem is suspected.

CMS RVU26DEffective Oct 1, 2026One payment locality10K Medicare services in 2024

In Connecticut, Medicare pays $139.06 for 49465 in the office and $26.82 when it’s performed in a hospital or facility.

$139.06Office (non-facility)
$26.82Hospital or facility
+7.0%vs the national office rate ($129.93)

Check a contract rate as a % of Medicare · 49465 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 49465 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 49465 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 49465 covers

A physician, commonly a radiologist, evaluates an indwelling gastrostomy, duodenostomy, jejunostomy, gastrojejunostomy, or colostomy tube by injecting contrast through it and observing the flow under fluoroscopy. The study can help assess tube position, patency, or suspected leakage. It is performed in a radiology department or another setting equipped for fluoroscopic imaging when the clinical question calls for a contrast examination of the existing tube.

Report 49465 for the fluoroscopic examination, including the contrast injection or injections, image documentation, and report. The record should identify the tube examined, the reason for the study, the contrast findings, and the interpretation. This is a diagnostic examination, not a tube replacement or repositioning service. It has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur 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. 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 Connecticut compares for 49465

Across 109 of 109 payment localities, the office rate for 49465 runs from $113.75 in Arkansas to $178.89 in San Benito County, CA. Connecticut pays $139.06. The RVUs are the same everywhere; the geographic indexes change the dollars.

49465 in Connecticut vs other payment areas
  1. Connecticut · this page$139.06
  2. Los Angeles, CA · California$149.82+$10.76
  3. Washington, DC area · District of Columbia$150.44+$11.38
  4. Miami, FL · Florida$137.42−$1.64
  5. Chicago, IL · Illinois$133.20−$5.86
  6. Manhattan, NY · New York$149.86+$10.80
  7. Alaska · Alaska$146.06+$7.00

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

Every other payment area

49465 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$115.57$24.39
ArkansasArkansas$113.75$24.23
ArizonaArizona$126.30$25.32
Bakersfield, CACalifornia$139.88$25.67
Chico, CACalifornia$139.70$25.48
El Centro, CACalifornia$139.71$25.49
Fresno, CACalifornia$139.70$25.48
Hanford, CACalifornia$139.70$25.48

49465 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.

$113.75

$159.30

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

View every state and territory as a table
49465 office rate range by state
State / territoryOffice rate rangeLocalities
AK$146.061
AL$115.571
AR$113.751
AZ$126.301
CA$139.70–$178.8929
CO$136.641
CT$139.061
DC$150.441
DE$128.531
FL$126.19–$137.423
GA$118.66–$132.122
GU$143.871
HI$143.871
IA$119.551
ID$120.241
IL$121.67–$134.534
IN$121.021
KS$118.581
KY$117.781
LA$117.44–$123.842
MA$135.56–$151.462
MD$131.26–$150.443
ME$120.54–$128.222
MI$120.80–$127.532
MN$131.651
MO$114.99–$124.763
MS$114.411
MT$129.931
NC$121.981
ND$128.741
NE$120.381
NH$134.101
NJ$140.85–$148.592
NM$121.381
NV$129.701
NY$123.94–$153.325
OH$120.561
OK$117.941
OR$128.90–$141.712
PA$120.97–$135.102
PR$131.091
RI$133.651
SC$121.431
SD$128.601
TN$119.181
TX$120.08–$136.008
UT$123.251
VA$127.51–$150.442
VI$131.091
VT$127.861
WA$135.43–$155.052
WI$124.011
WV$116.661
WY$129.411

See 49465 in every payment locality

How the 49465 rate is calculated

Each of 49465’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 · 49465

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.60

0.60 RVUs× 1.000 GPCI

Practice expense3.23

3.23 RVUs× 1.000 GPCI

Malpractice0.06

0.06 RVUs× 1.000 GPCI

Adjusted RVUs

3.8900

Conversion factor

$33.4009

Medicare rate

$129.93

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,820

Code
49465
Physician work
0.60
Practice expense
3.23
Malpractice
0.06

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 49465 in Connecticut
ComponentRVULocality factorAdjusted
Physician work0.60× 1.0200.6120
Practice expense3.23× 1.0773.4787
Malpractice0.06× 1.2100.0726
Total RVUs4.1633
Conversion factor× 33.4009

Office rate, Connecticut$139.06

Office: (0.6 × 1.02 + 3.23 × 1.077 + 0.06 × 1.21) × $33.4009 = $139.06

Facility: (0.6 × 1.02 + 0.11 × 1.077 + 0.06 × 1.21) × $33.4009 = $26.82

Open 49465 in the RVU calculator

Payment rules and modifiers for 49465

The CMS indicators that decide how 49465 is paid alongside other services.

CMS payment indicators · 49465

Tube examination, fluoroscopic contrast study

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

49465 without 51 · national office

$129.93

Tube examination, fluoroscopic contrast study

49465-51 · Second procedure: 50%

$64.97

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

How 49465 has changed in Connecticut

49465 · Office / nonfacility

$139.06

Effective 2026-10-01

The base rate is $0.90 lower than on 2025-10-01, moving from $139.96 to $139.06 (0.6%).

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

    $139.96changed to$139.06

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.62 changed to 0.60
    • Practice expense RVU 3.33 changed to 3.23
    • Malpractice RVU 0.05 changed to 0.06
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $146.62changed to$139.96

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.39 changed to 3.33
    • Malpractice RVU 0.06 changed to 0.05

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $144.22changed to$146.62

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $151.90changed to$144.22

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.43 changed to 3.39
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207
  5. January 1, 2023

    RVU23A

    $156.10changed to$151.90

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.05 changed to 0.06
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $167.50changed to$156.10

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.69 changed to 3.43

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $172.41changed to$167.50

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.67 changed to 3.69
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $177.76changed to$172.41

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.81 changed to 3.67
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $184.77changed to$177.76

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.99 changed to 3.81

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $184.94changed to$184.77

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $184.28changed to$184.94

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.97 changed to 3.99
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $184.14changed to$184.28

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.95 changed to 3.97

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $183.22changed to$184.14

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $188.06changed to$183.22

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.08 changed to 3.95
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $188.74changed to$188.06

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.37 changed to 4.08
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $188.74

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$139.06$26.82RVU26D
2026-07-01$139.06$26.82RVU26C
2026-04-01$139.06$26.82RVU26B
2026-01-01$139.06$26.82RVU26A
2025-10-01$139.96$30.21RVU25D
2025-07-01$139.96$30.21RVU25C
2025-04-01$139.96$30.21RVU25B
2025-01-01$139.96$30.21RVU25A
2024-10-01$146.62$31.13RVU24D
2024-07-01$146.62$31.13RVU24C
2024-04-01$146.62$31.13RVU24B
2024-03-09$146.62$31.13RVU24AR
2024-01-01$144.22$30.62RVU24A
2023-10-01$151.90$32.03RVU23D
2023-07-01$151.90$32.03RVU23C
2023-04-01$151.90$32.03RVU23B
2023-01-01$151.90$32.03RVU23A
2022-10-01$156.10$31.96RVU22D
2022-07-01$156.10$31.96RVU22C
2022-04-01$156.10$31.96RVU22B
2022-01-01$156.10$31.96RVU22A
2021-10-01$167.50$32.62RVU21D
2021-07-01$167.50$32.62RVU21C
2021-04-01$167.50$32.62RVU21B
2021-01-01$167.50$32.62RVU21A
2020-10-01$172.41$33.84RVU20D
2020-07-01$172.41$33.84RVU20C
2020-04-01$172.41$33.84RVU20B
2020-01-01$172.41$33.84RVU20A
2019-10-01$177.76$33.89RVU19D
2019-07-01$177.76$33.89RVU19C
2019-04-01$177.76$33.89RVU19B
2019-01-01$177.76$33.89RVU19A
2018-10-01$184.77$33.85RVU18D
2018-07-01$184.77$33.85RVU18C
2018-04-01$184.77$33.85RVU18B
2018-01-01$184.77$33.85RVU18AR1
2017-10-01$184.94$34.22RVU17D
2017-07-01$184.94$34.22RVU17C
2017-04-01$184.94$34.22RVU17B
2017-01-01$184.94$34.22RVU17A
2016-10-01$184.28$34.17RVU16D
2016-07-01$184.28$34.17RVU16C
2016-04-01$184.28$34.17RVU16B
2016-01-01$184.28$34.17RVU16A
2015-10-01$184.14$34.29RVU15D
2015-07-01$184.14$34.29RVU15C
2015-04-01$183.22$34.12RVU15B
2015-01-01$183.22$34.12RVU15A
2014-10-01$188.06$33.75RVU14D
2014-07-01$188.06$33.75RVU14C
2014-04-01$188.06$33.75RVU14B
2014-01-01$188.06$33.75RVU14A
2013-10-01$188.74$32.01RVU13D
2013-07-01$188.74$32.01RVU13C
2013-04-01$188.74$32.01RVU13B
2013-01-01$188.74$32.01RVU13AR

Price 49465 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

49465 billing questions

When should 49465 be selected instead of a tube replacement code?

Use 49465 when the service is a fluoroscopic contrast examination of the existing tube. Use a replacement code when the tube is actually exchanged.

Are contrast injection and image documentation separately reported?

They are included in 49465 along with the fluoroscopic examination and report.

Can modifier 50 be used for tubes on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code.

What documentation supports reporting 49465?

Document the tube examined, the clinical reason for the study, contrast administration, fluoroscopic findings, and the interpretation.

How does the multiple-procedure reduction affect 49465?

When it is performed in the same session as other procedures, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.

Can an assistant or co-surgeon be reported?

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 49465PPRRVU2026_Oct_nonQPP.csv, line 5,820 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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