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CPT code 49905: Omental flap, intra-abdominal placement2026 Medicare rate & RVUs

Reports additional surgical work to mobilize and position omentum within the abdomen as a flap during a qualifying primary abdominal procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities7.7K Medicare services in 2024

Medicare pays $314.97 for 49905 nationally in a facility.

Medicare rate · 49905

Omental flap, intra-abdominal placement

Office or facility?

Work RVUs
6.38
Total RVUs
9.43
Global days
ZZZ

National rate · 2026

$314.97

Facility setting, before claim adjustments.

See every locality for 49905 →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.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 49905 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 49905 covers

49905 captures the surgeon’s additional work of mobilizing and positioning omental tissue as a flap that remains inside the abdominal cavity, such as to cover or reinforce an intra-abdominal defect or support repair of an intra-abdominal fistula. It is performed during an abdominal operation, typically by a general or colorectal surgeon in an operating room.

Report 49905 only with a qualifying primary procedure; it is not a standalone service. Select it when the flap is placed intra-abdominally, rather than carried outside the abdomen or transferred as a free flap with microvascular anastomosis. The operative report should identify the omentum used, its mobilization and final placement, the target or defect addressed, and the primary operation. CMS classifies 49905 as an add-on code and pays it within the primary procedure’s global period.

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 49905 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

49905 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$286.96
AlaskaUnavailable$402.73
ArizonaUnavailable$306.23
ArkansasUnavailable$283.60
Atlanta, GAUnavailable$326.38
Austin, TXUnavailable$312.80
Bakersfield, CAUnavailable$304.73
Baltimore area, MDUnavailable$333.92
Beaumont, TXUnavailable$306.74
Brazoria, TXUnavailable$305.33

49905 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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.

View every state and territory as a table
49905 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 49905 rate is calculated

Each of 49905’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 · 49905

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.38

6.38 RVUs× 1.000 GPCI

Practice expense1.57

1.57 RVUs× 1.000 GPCI

Malpractice1.48

1.48 RVUs× 1.000 GPCI

Adjusted RVUs

9.4300

Conversion factor

$33.4009

Medicare rate

$314.97

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

Payment rules and modifiers for 49905

The CMS indicators that decide how 49905 is paid alongside other services.

CMS payment indicators · 49905

Omental flap, intra-abdominal placement

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

49905 without 80 · national facility

$314.97

Omental flap, intra-abdominal placement

49905-80 · Assistant: 16%

$50.40

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

49905 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 49905

    Omental flap, intra-abdominal placement6.38 wRVU

    Not priced

  • 49904

    Omental flap, extra-abdominal transfer21.79 wRVU

    Not priced

  • 49906

    Free omental flap, microvascular anastomosis0 wRVU

    Not priced

  • 49999

    Unlisted abdominal procedure, abdomen, peritoneum, omentum0 wRVU

    Not priced

How to choose

49904Omental flapExtra-abdominal transfer
Choose 49905 when the omental flap remains within the abdominal cavity; 49904 describes an extra-abdominal flap.
49906Free omental flapMicrovascular anastomosis
49906 describes a free omental flap transferred with microvascular anastomosis, rather than an intra-abdominal flap placement.
49999Unlisted abdominal procedureAbdomen, peritoneum, omentum
Use 49905 when its listed intra-abdominal flap service fits; 49999 is for an abdominal procedure without a specific listed code.

Codes related to 49905

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

Codes related to 49905
CodeHow it relatesNational office range
Same family
49904Omental flap, extra-abdominal transferRelated omental flap code for extra-abdominal placement.No office rate
49906Free omental flap, microvascular anastomosisRelated code for a free omental flap with microvascular anastomosis.No office rate
Used instead
49999Unlisted abdominal procedure, abdomen, peritoneum, omentumUnlisted abdominal procedure code when no listed code describes the service.No office rate

49905 billing questions

Can 49905 be reported by itself?

No. It is an add-on code and must be billed with a primary procedure.

How does 49905 differ from 49904?

49905 is for an omental flap placed within the abdomen. 49904 describes an extra-abdominal flap.

When is 49906 a better fit?

Use 49906 for a free omental flap transferred with microvascular anastomosis. 49905 describes an intra-abdominal flap.

What should the operative report document?

Document the omentum mobilized, its intra-abdominal destination, the defect or target addressed, and the primary procedure performed.

What is the global-period treatment for 49905?

CMS treats 49905 as an add-on paid within the primary procedure’s global period.

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 49905PPRRVU2026_Oct_nonQPP.csv, line 5,862 (RVU26D)

Open CMS sourceHow we calculate rates

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