Billing code 49400: PeritoneographyMedicare rate & RVUs
Peritoneography reports injection of air or contrast into the peritoneal cavity to create an imageable study of the abdominal cavity.
Medicare pays $150.64 for 49400 nationally in the office and $78.49 in a hospital or facility. Local office rates run $135.60–$190.57.
Medicare rate · 49400
Peritoneography
Swap in your local Medicare rate.
- Work RVUs
- 1.83
- Total RVUs
- 4.51
- Global days
- 000
National rate · 2026
$150.64
Office setting, before claim adjustments.
See every locality for 49400 → · 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
What 49400 covers
Peritoneography creates an imageable outline of the peritoneal cavity by introducing air or contrast, with imaging guidance when performed. A radiologist or other physician performs the injection in a procedural or imaging setting to investigate a clinical question involving the peritoneal cavity. The target is the general peritoneal space, not a localized cyst or fluid collection and not a site being treated with a drainage catheter.
Report the service when the documented procedure injects material into the peritoneal cavity for peritoneographic imaging; documentation should identify the injection and the imaging purpose. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, 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 49400 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$135.60 to $190.57
109 of 109 payment localities
49400 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.
$135.60
$183.41
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $183.41 | 1 |
| AL | $137.28 | 1 |
| AR | $135.60 | 1 |
| AZ | $147.07 | 1 |
| CA | $156.34–$190.57 | 29 |
| CO | $155.12 | 1 |
| CT | $159.69 | 1 |
| DC | $169.42 | 1 |
| DE | $149.25 | 1 |
| FL | $150.54–$164.75 | 3 |
| GA | $143.07–$153.55 | 2 |
| GU | $158.99 | 1 |
| HI | $158.99 | 1 |
| IA | $139.40 | 1 |
| ID | $140.34 | 1 |
| IL | $147.41–$160.56 | 4 |
| IN | $141.01 | 1 |
| KS | $139.24 | 1 |
| KY | $140.88 | 1 |
| LA | $140.86–$146.72 | 2 |
| MA | $154.56–$168.38 | 2 |
| MD | $151.66–$169.42 | 3 |
| ME | $141.39–$147.31 | 2 |
| MI | $144.37–$152.56 | 2 |
| MN | $148.09 | 1 |
| MO | $139.07–$146.69 | 3 |
| MS | $137.34 | 1 |
| MT | $150.62 | 1 |
| NC | $142.58 | 1 |
| ND | $146.47 | 1 |
| NE | $139.92 | 1 |
| NH | $153.14 | 1 |
| NJ | $161.35–$168.17 | 2 |
| NM | $145.20 | 1 |
| NV | $149.55 | 1 |
| NY | $144.43–$176.15 | 5 |
| OH | $143.52 | 1 |
| OK | $140.25 | 1 |
| OR | $148.22–$158.98 | 2 |
| PA | $143.49–$156.47 | 2 |
| PR | $151.44 | 1 |
| RI | $153.76 | 1 |
| SC | $143.32 | 1 |
| SD | $145.98 | 1 |
| TN | $139.88 | 1 |
| TX | $142.72–$154.75 | 8 |
| UT | $144.97 | 1 |
| VA | $147.17–$169.42 | 2 |
| VI | $151.44 | 1 |
| VT | $146.35 | 1 |
| WA | $154.13–$171.14 | 2 |
| WI | $142.32 | 1 |
| WV | $142.85 | 1 |
| WY | $148.81 | 1 |
How the 49400 rate is calculated
Each of 49400’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 · 49400
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.83Practice expense 2.47Malpractice 0.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49400
The CMS indicators that decide how 49400 is paid alongside other services.
CMS payment indicators · 49400
Peritoneography
| 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
49400 without 51 · national office
$150.64
Peritoneography
49400-51 · Second procedure: 50%
$75.32
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%).
49400 compared with similar codes
Compare codes
49400 vs 49424 vs 49405 vs 49406: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 49424Cavity contrast study
- Choose 49400 when the injection opacifies the peritoneal cavity; choose 49424 when the injection is into a localized abscess, cyst, or other fluid collection for diagnostic evaluation.
- 49405Visceral drainage
- 49405 describes image-guided catheter drainage of a visceral fluid collection. It is not the peritoneal cavity injection performed for peritoneography.
- 49406Catheter drainage
- 49406 is for image-guided catheter drainage of a peritoneal or retroperitoneal fluid collection; 49400 is an injection procedure for imaging the general peritoneal cavity.
49400 billing questions
How is 49400 distinguished from 49424?
49400 is for injection into the general peritoneal cavity to create a peritoneogram. 49424 is for injection into an abscess, cyst, or other fluid collection for diagnostic evaluation.
Is imaging guidance separately reported?
Imaging guidance, when performed, is included in 49400. The code describes the injection procedure and the associated peritoneographic imaging guidance.
Can modifier 50 be used?
No. Bilateral adjustment does not apply to 49400, and modifier 50 is inappropriate for this service.
What documentation supports reporting 49400?
Document the injection into the peritoneal cavity, the injected material, and the purpose of obtaining peritoneographic imaging. Distinguish the general peritoneal space from a localized fluid collection.
How does the multiple-procedure rule affect payment?
When 49400 is performed with other procedures in the same session, 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 is restricted for 49400. 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
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