CPT 49013: Pelvic packingMedicare rate & RVUs
Reports preperitoneal pelvic packing to control traumatic hemorrhage, typically during operative management of a hemodynamically unstable pelvic fracture.
Medicare pays $410.16 for 49013 nationally in a facility.
Medicare rate · 49013
Pelvic packing
Swap in your local Medicare rate.
- Work RVUs
- 8.14
- Total RVUs
- 12.28
- Global days
- 000
National rate · 2026
$410.16
Facility setting, before claim adjustments.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 49013 covers
This code describes operative packing through a preperitoneal approach to tamponade bleeding in the pelvis after trauma. A trauma or acute care surgeon typically performs it in the operating room for a patient with severe pelvic bleeding, often associated with an unstable pelvic fracture. The approach targets pelvic hemorrhage; it is distinct from opening the abdomen to investigate intra-abdominal injuries or from angiographic embolization.
Report the code when the documented procedure includes preperitoneal pelvic packing for traumatic hemorrhage. The operative report should support the traumatic indication, approach, and packing performed. The 0-day global period includes same-day preoperative and postoperative care. 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. Medicare does not pay an assistant at surgery, and 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.
Where 49013 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
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Unavailable | $370.48 |
| Alaska* | Unavailable | $517.84 |
| Arizona | Unavailable | $397.69 |
| Arkansas | Unavailable | $365.73 |
| Atlanta | Unavailable | $426.60 |
| Austin | Unavailable | $406.26 |
| Bakersfield | Unavailable | $393.31 |
| Baltimore/Surr. Cntys | Unavailable | $436.49 |
| Beaumont | Unavailable | $399.09 |
| Brazoria | Unavailable | $395.80 |
| Chicago | Unavailable | $506.26 |
| Chico | Unavailable | $387.47 |
| Colorado | Unavailable | $401.76 |
| Connecticut | Unavailable | $435.89 |
| Dallas | Unavailable | $402.05 |
| Dc + Md/Va Suburbs | Unavailable | $444.75 |
| Delaware | Unavailable | $403.41 |
| Detroit | Unavailable | $457.58 |
| East St. Louis | Unavailable | $478.39 |
| El Centro | Unavailable | $387.83 |
| Fort Lauderdale | Unavailable | $469.58 |
| Fort Worth | Unavailable | $402.34 |
| Fresno | Unavailable | $387.47 |
| Galveston | Unavailable | $399.41 |
| Hanford-Corcoran | Unavailable | $387.47 |
| Hawaii, Guam | Unavailable | $388.66 |
| Houston | Unavailable | $439.13 |
| Idaho | Unavailable | $366.70 |
| Indiana | Unavailable | $368.10 |
| Iowa | Unavailable | $360.86 |
| Kansas | Unavailable | $367.90 |
| Kentucky | Unavailable | $396.70 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Unavailable | $409.00 |
| Madera | Unavailable | $387.47 |
| Manhattan | Unavailable | $480.70 |
| Merced | Unavailable | $387.47 |
| Metropolitan Boston | Unavailable | $426.10 |
| Metropolitan Kansas City | Unavailable | $404.48 |
| Metropolitan Philadelphia | Unavailable | $431.74 |
| Metropolitan St. Louis | Unavailable | $407.15 |
| Miami | Unavailable | $523.68 |
| Minnesota | Unavailable | $361.05 |
| Mississippi | Unavailable | $382.10 |
| Modesto | Unavailable | $387.47 |
| Montana** | Unavailable | $410.02 |
| Napa | Unavailable | $412.56 |
| Nebraska | Unavailable | $360.01 |
| Nevada** | Unavailable | $398.12 |
| New Hampshire | Unavailable | $403.80 |
| New Mexico | Unavailable | $419.27 |
| New Orleans | Unavailable | $416.14 |
| North Carolina | Unavailable | $379.59 |
| North Dakota** | Unavailable | $367.11 |
| Northern Nj | Unavailable | $442.75 |
| Nyc Suburbs/Long Island | Unavailable | $502.12 |
| Ohio | Unavailable | $405.02 |
| Oklahoma | Unavailable | $386.96 |
| Oxnard-Thousand Oaks-Ventura | Unavailable | $402.43 |
| Portland | Unavailable | $403.26 |
| Poughkpsie/N Nyc Suburbs | Unavailable | $443.87 |
| Puerto Rico | Unavailable | $409.80 |
| Queens | Unavailable | $471.58 |
| Redding | Unavailable | $387.47 |
| Rest Of California | Unavailable | $387.47 |
| Rest Of Florida | Unavailable | $443.73 |
| Rest Of Georgia | Unavailable | $416.97 |
| Rest Of Illinois | Unavailable | $445.24 |
| Rest Of Louisiana | Unavailable | $399.55 |
| Rest Of Maine | Unavailable | $377.50 |
| Rest Of Maryland | Unavailable | $407.73 |
| Rest Of Massachusetts | Unavailable | $403.29 |
| Rest Of Michigan | Unavailable | $413.79 |
| Rest Of Missouri | Unavailable | $399.20 |
| Rest Of New Jersey | Unavailable | $434.12 |
| Rest Of New York | Unavailable | $385.35 |
| Rest Of Oregon | Unavailable | $388.37 |
| Rest Of Pennsylvania | Unavailable | $400.78 |
| Rest Of Texas | Unavailable | $399.78 |
| Rest Of Washington | Unavailable | $399.86 |
| Rhode Island | Unavailable | $409.67 |
| Riverside-San Bernardino-Ontario | Unavailable | $410.72 |
| Sacramento-Roseville-Folsom | Unavailable | $397.05 |
| Salinas | Unavailable | $395.42 |
| San Diego-Chula Vista-Carlsbad | Unavailable | $398.02 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Unavailable | $423.76 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Unavailable | $421.29 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Unavailable | $435.52 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Unavailable | $425.45 |
| San Luis Obispo-Paso Robles | Unavailable | $390.30 |
| Santa Cruz-Watsonville | Unavailable | $396.39 |
| Santa Maria-Santa Barbara | Unavailable | $395.07 |
| Santa Rosa-Petaluma | Unavailable | $399.69 |
| Seattle (King Cnty) | Unavailable | $425.43 |
| South Carolina | Unavailable | $394.29 |
| South Dakota** | Unavailable | $362.04 |
| Southern Maine | Unavailable | $382.83 |
| Stockton | Unavailable | $387.47 |
| Suburban Chicago | Unavailable | $469.80 |
| Tennessee | Unavailable | $370.62 |
| Utah | Unavailable | $398.82 |
| Vallejo | Unavailable | $409.00 |
| Vermont | Unavailable | $373.70 |
| Virgin Islands | Unavailable | $409.80 |
| Virginia | Unavailable | $387.74 |
| Visalia | Unavailable | $387.47 |
| West Virginia | Unavailable | $432.78 |
| Wisconsin | Unavailable | $357.24 |
| Wyoming** | Unavailable | $391.32 |
| Yuba City | Unavailable | $387.47 |
49013 rates by state
Office rate range in each state. Select a state to see its payment localities.
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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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 49013 rate is calculated
Each of 49013’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 · 49013
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.14Practice expense 1.97Malpractice 2.17
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49013
The CMS indicators that decide how 49013 is paid alongside other services.
CMS payment indicators · 49013
Pelvic packing
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49013 without 51 · national facility
$410.16
Pelvic packing
49013-51 · Second procedure: 50%
$205.08
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%).
49013 compared with similar codes
Compare codes
49013 vs 49000 vs 49014 vs 37244: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 49000Abdominal exploration
- 49000 is for operative abdominal exploration to assess intra-abdominal pathology. Choose 49013 for preperitoneal pelvic packing directed at traumatic pelvic hemorrhage.
- 49014Pelvic re-exploration
- 49014 describes re-exploration of a pelvic wound, including removal of packing when performed. It represents a subsequent operative stage rather than the initial packing.
- 37244Vascular embolization
- 37244 reports vascular embolization or occlusion for hemorrhage. It describes an endovascular approach, rather than operative preperitoneal pelvic packing.
49013 billing questions
When should this code be chosen instead of 49000?
Use this code for preperitoneal pelvic packing to control traumatic pelvic hemorrhage. Code 49000 describes abdominal exploration; it is appropriate when a separate intra-abdominal injury requires exploration.
How does 49014 differ?
Code 49014 describes re-exploration of a pelvic wound, including removal of packing when performed. It is for a subsequent re-exploration, not the initial packing reported with 49013.
Can modifier 50 be used?
No. The anatomy and procedure make bilateral adjustment inappropriate.
Is an assistant surgeon payable?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are also not permitted.
How does the multiple-procedure reduction affect payment?
For multiple procedures in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% 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
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