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CMS RVU26D · Effective 2026-10-01

49442 in Austin

Office / nonfacility

$775.59

Base rate per service

Facility setting

$179.79

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Gastrointestinal procedure

About 49442: Percutaneous cecostomy tube placement

Report percutaneous cecostomy tube placement when a clinician establishes image-guided access to the cecum, often for antegrade bowel irrigation.

A clinician advances a tube through the abdominal wall into the cecum using percutaneous, fluoroscopic guidance. Interventional radiologists commonly perform this procedure in a facility setting. A cecostomy can provide access for antegrade colonic irrigation in patients with severe refractory constipation or neurogenic bowel. The service is distinct from access to the stomach, duodenum, or jejunum.

Report this code for placement of a new cecostomy tube, not routine exchange of an existing tube. Document the cecal target, percutaneous approach, tube placement, and imaging guidance. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures receive the standard multiple-procedure reduction. Report one unit for the cecal access; modifier 50 is inappropriate. An assistant is paid only when medical necessity is documented; co-surgeon and team-surgery reporting are not permitted.

CMS billing rules for 49442

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU3.66 · 16%
  • Practice expense (office) RVU18.18 · 82%
  • Malpractice RVU0.36 · 2%

31

Medicare services in 2024 · #5649 by national volume

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.

49442 compared with similar codes

Office rates for Austin, from the same CMS release.

49440

Gastrostomy placement

Percutaneous, image-guided

$824.35

Choose 49442 for a tube entering the cecum; choose 49440 when the percutaneous tube enters the stomach.

49441

Enteral tube placement

Duodenal or jejunal tube

$1,026.26

Choose 49442 for cecal access. Code 49441 identifies percutaneous placement targeting the duodenum or jejunum.

49450

Feeding tube replacement

Gastrostomy or cecostomy

$593.51

Use 49442 for new percutaneous cecostomy tube placement; use 49450 when replacing an existing gastrostomy or cecostomy tube.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 49442 is $686.00—$89.59 lower than the $775.59 rate in Austin. Both use the same code, release and participation basis.

49442 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $775.59

  2. Beaumont

    $686.00

    $89.59 lower than Austin

  3. Brazoria

    $734.37

    $41.22 lower than Austin

  4. Dallas

    $738.46

    $37.13 lower than Austin

  5. Fort Worth

    $732.55

    $43.04 lower than Austin

  6. Galveston

    $736.16

    $39.43 lower than Austin

  7. Houston

    $742.75

    $32.84 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 49442 ranges from $650.05 in Arkansas to $1017.76 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 49442

    Office

    $709.36

    Facility

    $174.95

    $66.23 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 49442

    Office

    $853.59

    Facility

    $187.40

    $78.00 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 49442

    Office

    $857.55

    Facility

    $194.17

    $81.96 higher than Austin for the office setting.

  • Miami

    Florida · 49442

    Office

    $784.78

    Facility

    $198.55

    $9.19 higher than Austin for the office setting.

  • Chicago

    Illinois · 49442

    Office

    $760.96

    Facility

    $195.01

    $14.63 lower than Austin for the office setting.

  • Manhattan

    New York · 49442

    Office

    $854.74

    Facility

    $200.37

    $79.15 higher than Austin for the office setting.

  • Alaska*

    Alaska · 49442

    Office

    $836.69

    Facility

    $236.95

    $61.10 higher than Austin for the office setting.

  • Alabama

    Alabama · 49442

    Office

    $660.38

    Facility

    $167.63

    $115.21 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 49442

    Office

    $650.05

    Facility

    $166.31

    $125.54 lower than Austin for the office setting.

  • Arizona

    Arizona · 49442

    Office

    $720.94

    Facility

    $175.26

    $54.65 lower than Austin for the office setting.

  • Bakersfield

    California · 49442

    Office

    $797.42

    Facility

    $180.21

    $21.83 higher than Austin for the office setting.

  • Chico

    California · 49442

    Office

    $796.29

    Facility

    $179.09

    $20.70 higher than Austin for the office setting.

  • El Centro

    California · 49442

    Office

    $796.35

    Facility

    $179.15

    $20.76 higher than Austin for the office setting.

  • Fresno

    California · 49442

    Office

    $796.29

    Facility

    $179.09

    $20.70 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 49442

    Office

    $796.29

    Facility

    $179.09

    $20.70 higher than Austin for the office setting.

  • Madera

    California · 49442

    Office

    $796.29

    Facility

    $179.09

    $20.70 higher than Austin for the office setting.

  • Merced

    California · 49442

    Office

    $796.29

    Facility

    $179.09

    $20.70 higher than Austin for the office setting.

  • Modesto

    California · 49442

    Office

    $796.29

    Facility

    $179.09

    $20.70 higher than Austin for the office setting.

  • Napa

    California · 49442

    Office

    $936.38

    Facility

    $194.17

    $160.79 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 49442

    Office

    $850.91

    Facility

    $185.27

    $75.32 higher than Austin for the office setting.

  • Redding

    California · 49442

    Office

    $796.29

    Facility

    $179.09

    $20.70 higher than Austin for the office setting.

  • Rest Of California

    California · 49442

    Office

    $796.29

    Facility

    $179.09

    $20.70 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 49442

    Office

    $800.23

    Facility

    $183.03

    $24.64 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 49442

    Office

    $839.30

    Facility

    $184.37

    $63.71 higher than Austin for the office setting.

  • Salinas

    California · 49442

    Office

    $836.26

    Facility

    $183.58

    $60.67 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 49442

    Office

    $858.68

    Facility

    $185.16

    $83.09 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 49442

    Office

    $995.57

    Facility

    $201.55

    $219.98 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 49442

    Office

    $995.16

    Facility

    $201.14

    $219.57 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 49442

    Office

    $1017.76

    Facility

    $205.72

    $242.17 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 49442

    Office

    $1016.09

    Facility

    $204.04

    $240.50 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 49442

    Office

    $822.40

    Facility

    $180.99

    $46.81 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 49442

    Office

    $869.04

    Facility

    $184.83

    $93.45 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 49442

    Office

    $840.14

    Facility

    $183.52

    $64.55 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 49442

    Office

    $878.04

    Facility

    $186.50

    $102.45 higher than Austin for the office setting.

  • Stockton

    California · 49442

    Office

    $796.29

    Facility

    $179.09

    $20.70 higher than Austin for the office setting.

  • Vallejo

    California · 49442

    Office

    $935.80

    Facility

    $193.58

    $160.21 higher than Austin for the office setting.

  • Visalia

    California · 49442

    Office

    $796.29

    Facility

    $179.09

    $20.70 higher than Austin for the office setting.

  • Yuba City

    California · 49442

    Office

    $796.29

    Facility

    $179.09

    $20.70 higher than Austin for the office setting.

  • Colorado

    Colorado · 49442

    Office

    $779.20

    Facility

    $180.02

    $3.61 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 49442

    Office

    $793.23

    Facility

    $186.73

    $17.64 higher than Austin for the office setting.

  • Delaware

    Delaware · 49442

    Office

    $733.61

    Facility

    $177.23

    $41.98 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 49442

    Office

    $759.11

    Facility

    $188.65

    $16.48 lower than Austin for the office setting.

  • Rest Of Florida

    Florida · 49442

    Office

    $720.83

    Facility

    $182.47

    $54.76 lower than Austin for the office setting.

  • Atlanta

    Georgia · 49442

    Office

    $754.00

    Facility

    $181.85

    $21.59 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 49442

    Office

    $678.23

    Facility

    $175.91

    $97.36 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 49442

    Office

    $819.63

    Facility

    $179.34

    $44.04 higher than Austin for the office setting.

  • Iowa

    Iowa · 49442

    Office

    $682.63

    Facility

    $167.36

    $92.96 lower than Austin for the office setting.

  • Idaho

    Idaho · 49442

    Office

    $686.58

    Facility

    $168.50

    $89.01 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 49442

    Office

    $705.11

    Facility

    $187.03

    $70.48 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 49442

    Office

    $695.44

    Facility

    $181.29

    $80.15 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 49442

    Office

    $768.03

    Facility

    $189.69

    $7.56 lower than Austin for the office setting.

  • Indiana

    Indiana · 49442

    Office

    $690.99

    Facility

    $168.96

    $84.60 lower than Austin for the office setting.

  • Kansas

    Kansas · 49442

    Office

    $677.24

    Facility

    $168.16

    $98.35 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 49442

    Office

    $673.08

    Facility

    $172.44

    $102.51 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 49442

    Office

    $707.31

    Facility

    $177.39

    $68.28 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 49442

    Office

    $671.16

    Facility

    $172.79

    $104.43 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 49442

    Office

    $862.99

    Facility

    $190.60

    $87.40 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 49442

    Office

    $773.20

    Facility

    $180.21

    $2.39 lower than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 49442

    Office

    $790.63

    Facility

    $186.39

    $15.04 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 49442

    Office

    $749.02

    Facility

    $179.13

    $26.57 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 49442

    Office

    $688.38

    Facility

    $170.29

    $87.21 lower than Austin for the office setting.

  • Southern Maine

    Maine · 49442

    Office

    $731.60

    Facility

    $173.53

    $43.99 lower than Austin for the office setting.

  • Detroit

    Michigan · 49442

    Office

    $728.50

    Facility

    $185.07

    $47.09 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 49442

    Office

    $690.22

    Facility

    $176.08

    $85.37 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 49442

    Office

    $750.64

    Facility

    $171.17

    $24.95 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 49442

    Office

    $704.18

    Facility

    $175.39

    $71.41 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 49442

    Office

    $712.38

    Facility

    $176.27

    $63.21 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 49442

    Office

    $657.39

    Facility

    $171.96

    $118.20 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 49442

    Office

    $653.96

    Facility

    $169.09

    $121.63 lower than Austin for the office setting.

  • Montana**

    Montana · 49442

    Office

    $741.48

    Facility

    $178.34

    $34.11 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 49442

    Office

    $696.47

    Facility

    $171.07

    $79.12 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 49442

    Office

    $734.36

    Facility

    $171.22

    $41.23 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 49442

    Office

    $687.26

    Facility

    $167.49

    $88.33 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 49442

    Office

    $764.89

    Facility

    $178.67

    $10.70 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 49442

    Office

    $847.18

    Facility

    $193.93

    $71.59 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 49442

    Office

    $803.42

    Facility

    $188.47

    $27.83 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 49442

    Office

    $693.52

    Facility

    $177.12

    $82.07 lower than Austin for the office setting.

  • Nevada**

    Nevada · 49442

    Office

    $740.10

    Facility

    $176.40

    $35.49 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 49442

    Office

    $874.39

    Facility

    $204.82

    $98.80 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 49442

    Office

    $807.21

    Facility

    $190.58

    $31.62 higher than Austin for the office setting.

  • Queens

    New York · 49442

    Office

    $865.15

    Facility

    $199.52

    $89.56 higher than Austin for the office setting.

  • Rest Of New York

    New York · 49442

    Office

    $707.57

    Facility

    $172.59

    $68.02 lower than Austin for the office setting.

  • Ohio

    Ohio · 49442

    Office

    $688.77

    Facility

    $174.62

    $86.82 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 49442

    Office

    $673.85

    Facility

    $170.96

    $101.74 lower than Austin for the office setting.

  • Portland

    Oregon · 49442

    Office

    $807.78

    Facility

    $182.13

    $32.19 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 49442

    Office

    $735.50

    Facility

    $174.61

    $40.09 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 49442

    Office

    $770.92

    Facility

    $184.69

    $4.67 lower than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 49442

    Office

    $691.05

    Facility

    $174.08

    $84.54 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 49442

    Office

    $748.00

    Facility

    $178.67

    $27.59 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 49442

    Office

    $762.56

    Facility

    $180.84

    $13.03 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 49442

    Office

    $693.55

    Facility

    $173.21

    $82.04 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 49442

    Office

    $733.52

    Facility

    $170.38

    $42.07 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 49442

    Office

    $680.67

    Facility

    $168.78

    $94.92 lower than Austin for the office setting.

  • Utah

    Utah · 49442

    Office

    $703.84

    Facility

    $174.49

    $71.75 lower than Austin for the office setting.

  • Virginia

    Virginia · 49442

    Office

    $727.64

    Facility

    $174.08

    $47.95 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 49442

    Office

    $748.00

    Facility

    $178.67

    $27.59 lower than Austin for the office setting.

  • Vermont

    Vermont · 49442

    Office

    $729.49

    Facility

    $171.98

    $46.10 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 49442

    Office

    $772.40

    Facility

    $179.41

    $3.19 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 49442

    Office

    $883.25

    Facility

    $192.28

    $107.66 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 49442

    Office

    $707.68

    Facility

    $168.19

    $67.91 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 49442

    Office

    $667.14

    Facility

    $177.77

    $108.45 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 49442

    Office

    $738.37

    Facility

    $175.23

    $37.22 lower than Austin for the office setting.

See how rates vary across the country

49442 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$650.05

$907.03

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$836.691
AL$660.381
AR$650.051
AZ$720.941
CA$796.29–$1,017.7629
CO$779.201
CT$793.231
DC$857.551
DE$733.611
FL$720.83–$784.783
GA$678.23–$754.002
GU$819.631
HI$819.631
IA$682.631
ID$686.581
IL$695.44–$768.034
IN$690.991
KS$677.241
KY$673.081
LA$671.16–$707.312
MA$773.20–$862.992
MD$749.02–$857.553
ME$688.38–$731.602
MI$690.22–$728.502
MN$750.641
MO$657.39–$712.383
MS$653.961
MT$741.481
NC$696.471
ND$734.361
NE$687.261
NH$764.891
NJ$803.42–$847.182
NM$693.521
NV$740.101
NY$707.57–$874.395
OH$688.771
OK$673.851
OR$735.50–$807.782
PA$691.05–$770.922
PR$748.001
RI$762.561
SC$693.551
SD$733.521
TN$680.671
TX$686.00–$775.598
UT$703.841
VA$727.64–$857.552
VI$748.001
VT$729.491
WA$772.40–$883.252
WI$707.681
WV$667.141
WY$738.371

Explore 49442 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 49442 in Austin, the physician’s office rate is $775.59 and the facility-setting rate is $179.79: a difference of $595.80.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 49442 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$853.15

$775.59 × 110% = $853.15

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 49442 in Austin.

PPRRVU2026_Oct_nonQPP.csv

5,814

Code
49442
Physician work
3.66
Practice expense
18.18
Malpractice
0.36

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 49442 in Austin
ComponentRVULocality factorAdjusted
Physician work3.66× 1.0023.6673
Practice expense18.18× 1.05819.2344
Malpractice0.36× 0.8860.3190
Total RVUs23.2207
Conversion factor× 33.4009

Office / nonfacility rate, Austin$775.59

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 49442 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.661.002
Practice expense18.181.058
Malpractice0.360.886

(3.66 × 1.002 + 18.18 × 1.058 + 0.36 × 0.886) × $33.4009 = $775.59

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.661.002
Practice expense1.321.058
Malpractice0.360.886

(3.66 × 1.002 + 1.32 × 1.058 + 0.36 × 0.886) × $33.4009 = $179.79

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

49442 · Office / nonfacility

$775.59

Effective 2026-10-01

The base rate is $14.24 higher than on 2025-10-01, moving from $761.35 to $775.59 (1.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $761.35changed to$775.59

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.75 changed to 3.66
    • Practice expense RVU 18.62 changed to 18.18
    • Malpractice RVU 0.34 changed to 0.36
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $761.35

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$775.59$179.79RVU26D
2026-07-01$775.59$179.79RVU26C
2026-04-01$775.59$179.79RVU26B
2026-01-01$775.59$179.79RVU26A
2025-10-01$761.35$200.37RVU25D
2025-07-01$761.35$200.37RVU25C
2025-04-01$761.35$200.37RVU25B
2025-01-01$761.35$200.37RVU25A

49442 billing questions

How is this different from percutaneous gastrostomy placement?

This code is for a tube placed into the cecum. Use the gastrostomy code when the tube enters the stomach.

How is this different from duodenal or jejunal tube placement?

The target anatomy controls code selection: this service accesses the cecum, while the related code for duodenal or jejunal placement targets the small bowel.

Can this code be used for replacement of an existing cecostomy tube?

No. This code describes placement of a new tube; code 49450 describes percutaneous replacement of a gastrostomy or cecostomy tube.

Should modifier 50 be reported?

No. A single cecal access is reported once, and modifier 50 is inappropriate for this procedure.

What postoperative care is included?

Related postoperative visits during the 10-day global period are included in the procedure payment.

When is an assistant payable?

Assistant-at-surgery payment requires documentation of medical necessity. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 49442PPRRVU2026_Oct_nonQPP.csv, line 5,814 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet