Billing code 49411: Fiducial placementMedicare rate & RVUs

Medicare pays $470.62 for 49411 nationally in the office and $158.32 in a hospital or facility. Local office rates run $416.51–$629.15.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 49411 covers

This service places one or more small markers, such as fiducials, through the skin into an abdominal, pelvic, or retroperitoneal target so the radiation oncology team can localize it for treatment. Interventional radiologists commonly perform the placement, often using imaging to guide the needle. Examples include marking a tumor or treatment target before focused radiation such as stereotactic body radiation therapy.

Report 49411 for percutaneous placement at the specified sites, whether one or multiple devices are placed. The record should identify the target, percutaneous approach, and placement for radiation guidance. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 49411 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

49411 rates by state

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

How the 49411 rate is calculated

Each of 49411’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.

Payment rules and modifiers for 49411

The CMS indicators that decide how 49411 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

49411 compared with similar codes

How to choose

49412Radiation markers

Use 49411 for percutaneous placement at an abdominal, pelvic, or retroperitoneal site; 49412 describes open placement.

55876Prostate markers

This code is for prostate-target marker placement. Use 49411 for the covered abdominal, pelvic, or retroperitoneal targets outside that prostate-specific service.

32553Radiation marker

This code addresses percutaneous placement for an intrathoracic target; 49411 is for an abdominal, pelvic, or retroperitoneal target.

31626Fiducial placement

31626 places fiducials through bronchoscopy for a pulmonary target. 49411 uses a percutaneous approach for an abdominal, pelvic, or retroperitoneal target.

Codes related to 49411

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

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