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Billing code 49419: Peritoneal catheterMedicare rate & RVUs

Reports placement of a tunneled catheter with an implanted subcutaneous port for repeated access to the peritoneal cavity, commonly for intraperitoneal therapy.

CMS RVU26DEffective Oct 1, 2026109 payment localities86 Medicare services in 2024

Medicare pays $391.46 for 49419 nationally in a facility.

Medicare rate · 49419

Peritoneal catheter

Swap in your local Medicare rate.

Work RVUs
6.9
Total RVUs
11.72
Global days
090

National rate · 2026

$391.46

Facility setting, before claim adjustments.

See every locality for 49419 → · 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 49419 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 49419 covers

This service places a tunneled catheter into the peritoneal cavity and connects it to a port implanted beneath the skin. The port allows repeated access without leaving an external catheter segment. A surgeon, often working with a gynecologic oncology team, may place it to support repeated intraperitoneal chemotherapy. Placement is generally performed in an operative setting; the operative report should identify the catheter and port, their placement, and the clinical purpose.

Select this code for the tunneled intraperitoneal catheter-and-port configuration, rather than a percutaneous tunneled catheter without a port or a catheter placed for peritoneal dialysis. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 multiple-procedure reduction. Medicare does not pay for 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 49419 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

49419 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$354.92
Alaska*Unavailable$489.86
ArizonaUnavailable$380.47
ArkansasUnavailable$350.49
AtlantaUnavailable$404.55
AustinUnavailable$392.12
BakersfieldUnavailable$385.43
Baltimore/Surr. CntysUnavailable$415.61
BeaumontUnavailable$377.98
BrazoriaUnavailable$380.65

49419 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
49419 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 49419 rate is calculated

Each of 49419’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 · 49419

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.90Practice expense 3.23Malpractice 1.59

11.7200 adjusted RVUs×$33.4009 conversion factor=$391.46

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

Payment rules and modifiers for 49419

49419 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 49419

Peritoneal catheter

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 49419

Peritoneal catheter

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49419 without 51 · national facility

$391.46

Peritoneal catheter

49419-51 · Second procedure: 50%

$195.73

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

49419 compared with similar codes

Compare codes

49419 vs 49418 vs 49421 vs 49422: national Medicare rates

Swap in your local Medicare rate.

  • 49419
    Peritoneal catheter · 6.9 wRVU
    —
  • 49418
    Peritoneal catheter · 3.86 wRVU
    $939.57
  • 49421
    Dialysis catheter placement · 4.1 wRVU
    —
  • 49422
    Catheter removal · 3.9 wRVU
    —

How to choose

49418Peritoneal catheter
Choose 49419 when the tunneled intraperitoneal catheter is connected to a subcutaneous port. Code 49418 describes percutaneous placement without that port configuration.
49421Dialysis catheter placement
Code 49421 describes open placement of a tunneled intraperitoneal catheter for dialysis. This code is for a catheter with a subcutaneous port, commonly used for repeated intraperitoneal therapy.
49422Catheter removal
Code 49422 is for removal of a tunneled intraperitoneal catheter. Use 49419 for placement of the catheter-and-port system, not its later removal.

Codes related to 49419

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

Codes related to 49419
CodeHow it relatesNational office range
Used instead
49418Peritoneal catheterTunneled intraperitoneal catheter placement without the subcutaneous-port configuration.$820.21–$1,298.74
Same family
49421Dialysis catheter placementOpen placement of a tunneled intraperitoneal catheter for dialysis.No office rate
49422Catheter removalRemoval of a tunneled intraperitoneal catheter, rather than initial placement.No office rate

49419 billing questions

How does this differ from 49418?

49419 describes a tunneled intraperitoneal catheter connected to a subcutaneous port. Code 49418 is for a percutaneous tunneled intraperitoneal catheter without that port configuration.

Is the port included in this service?

Yes. The port is part of the catheter-and-port placement described by this code; it is not a separate service merely because it is implanted beneath the skin.

What documentation supports reporting 49419?

The operative note should support placement of a tunneled intraperitoneal catheter with a subcutaneous port and state the clinical purpose, such as repeated intraperitoneal therapy.

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.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 49419PPRRVU2026_Oct_nonQPP.csv, line 5,800 (RVU26D)

Open CMS sourceHow we calculate rates

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