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CPT code 49999: Unlisted abdominal procedure, abdomen, peritoneum, omentum2026 Medicare rate & RVUs

Report 49999 for an abdominal, peritoneal, or omental operation when no listed CPT procedure accurately describes the service performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.3K Medicare services in 2024

Medicare rate · 49999

Unlisted abdominal procedure, abdomen, peritoneum, omentum

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
YYY

National rate · 2026

—

Not priced in the facility setting.

See every locality for 49999 →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 49999 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 49999 covers

CPT 49999 is the unlisted code for surgical work involving the abdomen, peritoneum, or omentum when no listed CPT procedure describes the service. A surgeon may report it for an abdominal operation that does not fit a more specific code, including work on abdominal or omental tissue. The operative report should identify the procedure performed, the anatomy involved, and the work done so the Medicare contractor can evaluate and price the claim.

Medicare assigns status C, meaning CMS publishes no national payment and the Medicare Administrative Contractor sets payment for each claim. The contractor also determines the global period. For procedures performed in the same session, the standard multiple procedure reduction applies: the highest-valued procedure is paid in full and the other procedures are paid at 50%. Compare the service with listed abdominal wall and omental flap codes before using this unlisted code.

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 49999 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

49999 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

49999 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.

View every state and territory as a table
49999 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 49999 rate is calculated

Each of 49999’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 · 49999

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

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

Payment rules and modifiers for 49999

The CMS indicators that decide how 49999 is paid alongside other services.

CMS payment indicators · 49999

Unlisted abdominal procedure, abdomen, peritoneum, omentum

RuleCMS valueWhat it means
Global periodYYYThe Medicare contractor sets the global period.
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)1Not paid (statutory restriction).
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49999 without 51 · national facility

$0.00

Unlisted abdominal procedure, abdomen, peritoneum, omentum

49999-51 · Second procedure: 50%

$0.00

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

49999 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 49999

    Unlisted abdominal procedure, abdomen, peritoneum, omentum0 wRVU

    Not priced

  • 49900

    Abdominal wall repair, incision disruption or evisceration12.1 wRVU

    Not priced

  • 49904

    Omental flap, extra-abdominal transfer21.79 wRVU

    Not priced

  • 49905

    Omental flap, intra-abdominal placement6.38 wRVU

    Not priced

  • 49906

    Free omental flap, microvascular anastomosis0 wRVU

    Not priced

How to choose

49900Abdominal wall repairIncision disruption or evisceration
49900 describes abdominal wall repair. Use 49999 only when that listed repair code does not describe the operation.
49904Omental flapExtra-abdominal transfer
49904 describes an extra-abdominal omental flap procedure. Report 49999 when the operation does not match that listed service.
49905Omental flapIntra-abdominal placement
49905 describes an intra-abdominal omental flap procedure. Report 49999 when the operation does not match that listed service.
49906Free omental flapMicrovascular anastomosis
49906 describes a free omental flap with microvascular work. Use 49999 when that specific service does not describe the procedure.

Codes related to 49999

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

Codes related to 49999
CodeHow it relatesNational office range
Used instead
49900Abdominal wall repair, incision disruption or eviscerationUse this listed abdominal wall repair code when it accurately describes the procedure.No office rate
49904Omental flap, extra-abdominal transferUse this listed code when the service is an extra-abdominal omental flap procedure.No office rate
49905Omental flap, intra-abdominal placementUse this listed code when the service is an intra-abdominal omental flap procedure.No office rate
49906Free omental flap, microvascular anastomosisUse this listed code when the service is a free omental flap with microvascular work.No office rate

49999 billing questions

When should I report 49999 instead of a listed abdominal procedure?

Use 49999 when no listed CPT procedure accurately describes the operation performed. If a specific code describes the service, report that code instead.

What documentation supports a claim for 49999?

The operative report should identify the procedure performed, the anatomy involved, and the work done so the Medicare contractor can evaluate and price the claim.

How does Medicare price 49999?

Status C means CMS publishes no national payment. The Medicare Administrative Contractor sets payment for each claim.

Does 49999 have a nationally set global period?

The Medicare contractor sets the global period for this code.

How are multiple procedures treated when 49999 is reported?

For procedures performed in the same session, the standard multiple procedure reduction applies: the highest-valued procedure is paid in full and the other procedures are paid at 50%.

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

Open CMS sourceHow we calculate rates

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