FeeBase
Log inGet started
Menu

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

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 Kansas, Medicare pays $118.58 for 49465 in the office and $24.37 when it’s performed in a hospital or facility.

$118.58Office (non-facility)
$24.37Hospital or facility
−8.7%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 Kansas
  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 Kansas 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. Kansas pays $118.58. The RVUs are the same everywhere; the geographic indexes change the dollars.

49465 in Kansas vs other payment areas
  1. Kansas · this page$118.58
  2. Los Angeles, CA · California$149.82+$31.24
  3. Washington, DC area · District of Columbia$150.44+$31.86
  4. Miami, FL · Florida$137.42+$18.84
  5. Chicago, IL · Illinois$133.20+$14.62
  6. Manhattan, NY · New York$149.86+$31.28
  7. Alaska · Alaska$146.06+$27.48

Other areas in Kansas 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.

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.

$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 Kansas 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

54

Locality
Kansas
Physician work
1.000
Practice expense
0.904
Malpractice
0.504
Office calculation for 49465 in Kansas
ComponentRVULocality factorAdjusted
Physician work0.60× 1.0000.6000
Practice expense3.23× 0.9042.9199
Malpractice0.06× 0.5040.0302
Total RVUs3.5502
Conversion factor× 33.4009

Office rate, Kansas$118.58

Office: (0.6 × 1 + 3.23 × 0.904 + 0.06 × 0.504) × $33.4009 = $118.58

Facility: (0.6 × 1 + 0.11 × 0.904 + 0.06 × 0.504) × $33.4009 = $24.37

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

Codes related to 49465

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

Codes related to 49465
CodeHow it relatesOffice range, Kansas
Used instead
49460Tube fixation, gastrostomy or cecostomyUsed when the service repositions a gastrostomy or cecostomy tube rather than examining it diagnostically.$646.67
49450Feeding tube replacement, gastrostomy or cecostomyReports percutaneous replacement of a gastrostomy or cecostomy tube, not a contrast examination alone.$512.24
49451Feeding tube exchange, duodenal or jejunal tubeReports percutaneous replacement of a duodenostomy or jejunostomy tube.$547.04
49452G-J tube replacement, percutaneous exchangeReports percutaneous replacement of a gastrojejunostomy tube.$662.57

How 49465 has changed in Kansas

49465 · Office / nonfacility

$118.58

Effective 2026-10-01

The base rate is $0.06 higher than on 2025-10-01, moving from $118.52 to $118.58 (0.1%).

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

    $118.52changed to$118.58

    • 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
    • Practice expense GPCI 0.906 changed to 0.904
    • Malpractice GPCI 0.540 changed to 0.504

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $123.95changed to$118.52

    • 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

    $121.93changed to$123.95

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $127.45changed to$121.93

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.43 changed to 3.39
    • Practice expense GPCI 0.907 changed to 0.906
    • Malpractice GPCI 0.499 changed to 0.540

  5. January 1, 2023

    RVU23A

    $130.03changed to$127.45

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.05 changed to 0.06
    • Practice expense GPCI 0.908 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.499

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $139.34changed to$130.03

    • 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

    $143.87changed to$139.34

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.67 changed to 3.69
    • Practice expense GPCI 0.910 changed to 0.908
    • Malpractice GPCI 0.536 changed to 0.458

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $148.54changed to$143.87

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.81 changed to 3.67
    • Practice expense GPCI 0.911 changed to 0.910
    • Malpractice GPCI 0.615 changed to 0.536

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $154.28changed to$148.54

    • 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

    $153.28changed to$154.28

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.907 changed to 0.911
    • Malpractice GPCI 0.639 changed to 0.615

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $151.74changed to$153.28

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.97 changed to 3.99
    • Practice expense GPCI 0.903 changed to 0.907
    • Malpractice GPCI 0.662 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $151.64changed to$151.74

    • 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

    $150.88changed to$151.64

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $155.06changed to$150.88

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.08 changed to 3.95
    • Practice expense GPCI 0.899 changed to 0.903
    • Malpractice GPCI 0.810 changed to 0.662

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $155.64changed to$155.06

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.37 changed to 4.08
    • Practice expense GPCI 0.894 changed to 0.899
    • Malpractice GPCI 0.957 changed to 0.810

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $155.64

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$118.58$24.37RVU26D
2026-07-01$118.58$24.37RVU26C
2026-04-01$118.58$24.37RVU26B
2026-01-01$118.58$24.37RVU26A
2025-10-01$118.52$27.38RVU25D
2025-07-01$118.52$27.38RVU25C
2025-04-01$118.52$27.38RVU25B
2025-01-01$118.52$27.38RVU25A
2024-10-01$123.95$28.05RVU24D
2024-07-01$123.95$28.05RVU24C
2024-04-01$123.95$28.05RVU24B
2024-03-09$123.95$28.05RVU24AR
2024-01-01$121.93$27.59RVU24A
2023-10-01$127.45$28.79RVU23D
2023-07-01$127.45$28.79RVU23C
2023-04-01$127.45$28.79RVU23B
2023-01-01$127.45$28.79RVU23A
2022-10-01$130.03$28.85RVU22D
2022-07-01$130.03$28.85RVU22C
2022-04-01$130.03$28.85RVU22B
2022-01-01$130.03$28.85RVU22A
2021-10-01$139.34$29.40RVU21D
2021-07-01$139.34$29.40RVU21C
2021-04-01$139.34$29.40RVU21B
2021-01-01$139.34$29.40RVU21A
2020-10-01$143.87$30.57RVU20D
2020-07-01$143.87$30.57RVU20C
2020-04-01$143.87$30.57RVU20B
2020-01-01$143.87$30.57RVU20A
2019-10-01$148.54$30.68RVU19D
2019-07-01$148.54$30.68RVU19C
2019-04-01$148.54$30.68RVU19B
2019-01-01$148.54$30.68RVU19A
2018-10-01$154.28$30.64RVU18D
2018-07-01$154.28$30.64RVU18C
2018-04-01$154.28$30.64RVU18B
2018-01-01$154.28$30.64RVU18AR1
2017-10-01$153.28$30.88RVU17D
2017-07-01$153.28$30.88RVU17C
2017-04-01$153.28$30.88RVU17B
2017-01-01$153.28$30.88RVU17A
2016-10-01$151.74$30.82RVU16D
2016-07-01$151.74$30.82RVU16C
2016-04-01$151.74$30.82RVU16B
2016-01-01$151.74$30.82RVU16A
2015-10-01$151.64$30.93RVU15D
2015-07-01$151.64$30.93RVU15C
2015-04-01$150.88$30.78RVU15B
2015-01-01$150.88$30.78RVU15A
2014-10-01$155.06$30.75RVU14D
2014-07-01$155.06$30.75RVU14C
2014-04-01$155.06$30.75RVU14B
2014-01-01$155.06$30.75RVU14A
2013-10-01$155.64$29.41RVU13D
2013-07-01$155.64$29.41RVU13C
2013-04-01$155.64$29.41RVU13B
2013-01-01$155.64$29.41RVU13AR

Price 49465 for an earlier date of service

Where the Kansas rate applies

Kansas is a Medicare payment area, not a city. Our Census mapping connects it to 740 cities and communities in Kansas. Some span more than one payment area; confirm with the service ZIP.

  • Abbyville
  • Abilene
  • Ada
  • Admire
  • Agenda
  • Agra
  • Albert
  • Alden

Browse all communities in Kansas

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 KansasGPCI2026.csv, line 54 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 49465 pays in Kansas?

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 49465 and the rest of your codes on one sheet

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

Join the waitlist