FeeBase
Log inGet started
Menu

Billing code 49084: Peritoneal lavageMedicare rate & RVUs

Diagnostic peritoneal lavage evaluates suspected intraperitoneal bleeding or contamination, most often during acute trauma assessment when fluid recovery may guide management.

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

Medicare pays $95.86 for 49084 nationally in a facility.

Medicare rate · 49084

Peritoneal lavage

Swap in your local Medicare rate.

Work RVUs
1.95
Total RVUs
2.87
Global days
000

National rate · 2026

$95.86

Facility setting, before claim adjustments.

See every locality for 49084 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 49084 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 49084 covers

Peritoneal lavage is a diagnostic abdominal procedure in which the clinician accesses the peritoneal cavity, instills sterile fluid, and retrieves it to assess for blood or other abnormal contents. It is most associated with acute trauma evaluation when intraperitoneal injury remains a concern; a trauma or general surgeon typically performs it in a hospital setting. Imaging guidance, when used, is included in this code.

Report 49084 for the lavage itself, rather than simple removal of ascitic fluid by paracentesis. Documentation should support the clinical concern, the access and lavage performed, and the recovered fluid or findings. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed 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 for this service. Medicare does not pay an assistant at surgery; 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 49084 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

49084 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$87.27
Alaska*Unavailable$122.53
ArizonaUnavailable$93.17
ArkansasUnavailable$86.24
AtlantaUnavailable$99.39
AustinUnavailable$95.13
BakersfieldUnavailable$92.57
Baltimore/Surr. CntysUnavailable$101.67
BeaumontUnavailable$93.39
BrazoriaUnavailable$92.86

49084 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
49084 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 49084 rate is calculated

Each of 49084’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 · 49084

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.95Practice expense 0.46Malpractice 0.46

2.8700 adjusted RVUs×$33.4009 conversion factor=$95.86

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 49084

The CMS indicators that decide how 49084 is paid alongside other services.

CMS payment indicators · 49084

Peritoneal lavage

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)1Not paid (statutory restriction).
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

49084 without 51 · national facility

$95.86

Peritoneal lavage

49084-51 · Second procedure: 50%

$47.93

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

49084 compared with similar codes

Compare codes

49084 vs 49082 vs 49083 vs 49000: national Medicare rates

Swap in your local Medicare rate.

  • 49084
    Peritoneal lavage · 1.95 wRVU
    —
  • 49082
    Paracentesis · 1.21 wRVU
    $245.16
  • 49083
    Paracentesis · 1.95 wRVU
    $284.24
  • 49000
    Abdominal exploration · 12.23 wRVU
    —

How to choose

49082Paracentesis
Choose 49082 for abdominal paracentesis without imaging when existing fluid is aspirated. Use 49084 for instillation and retrieval of fluid as a lavage.
49083Paracentesis
Choose 49083 for paracentesis performed with imaging guidance. Imaging guidance used during peritoneal lavage is included in 49084.
49000Abdominal exploration
49000 represents open abdominal exploration. 49084 represents peritoneal lavage for fluid assessment, not an open exploration of the abdomen.

Codes related to 49084

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

Codes related to 49084
CodeHow it relatesNational office range
Used instead
49082ParacentesisParacentesis without imaging when fluid is removed rather than lavage performed.$214.00–$334.05
49083ParacentesisParacentesis with imaging when the service is fluid removal rather than lavage.$250.93–$381.90
49000Abdominal explorationOpen abdominal exploration involves operative inspection rather than lavage-only fluid assessment.No office rate

49084 billing questions

How is lavage different from paracentesis?

Lavage involves instilling and retrieving fluid to assess the peritoneal cavity, often in trauma evaluation. Paracentesis removes existing abdominal fluid for diagnostic or therapeutic purposes.

Is imaging guidance separately reported with 49084?

No. Imaging guidance, when performed as part of the lavage, is included in this code.

Can modifier 50 be used?

No. The descriptor and anatomy make modifier 50 inappropriate; report the lavage service without bilateral reporting.

How does Medicare handle other procedures in the same session?

The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. 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 49084PPRRVU2026_Oct_nonQPP.csv, line 5,772 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 49084 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 49084 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →