No office rate
49425 is for placing a new peritoneovenous shunt. Choose 49426 when the operative service revises an existing shunt.
On this page
CMS RVU26D · Effective 2026-10-01
49425 in Chico
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$727.27
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.
Abdominal surgery
About 49425: Peritoneovenous shunt insertion
Reports surgical placement of a peritoneovenous shunt to move ascitic fluid from the abdominal cavity into the venous circulation.
This service places a shunt connecting the peritoneal cavity with the venous system, allowing ascitic fluid to flow into the circulation. It is generally performed by a surgeon in a hospital operating room for a patient with ascites when peritoneovenous diversion is selected. The operative record should identify the indication and document creation of the abdominal-to-venous shunt pathway and its placement.
Report 49425 for the shunt insertion itself, not for later revision, evaluation, ligation, or removal. Documentation should distinguish new placement from work on an existing shunt. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 49425
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.91 · 53%
- Practice expense (office) RVU7.26 · 32%
- Malpractice RVU3.18 · 14%
37
Medicare services in 2024 · #5539 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.
49425 compared with similar codes
Office rates for Chico, from the same CMS release.
No office rate
49429 reports removal of an existing abdominal-venous shunt; it does not describe initial shunt placement.
$1,011.35
49418 describes insertion of a tunneled intraperitoneal catheter. It does not create the peritoneal-to-venous shunt reported with 49425.
$899.97
49405 describes image-guided catheter drainage of a visceral fluid collection, rather than surgical placement of a peritoneovenous shunt.
The same code, a different location
How does Chico compare?
49425 across payment areas
Same release and payment basis · bars start at $0
Chico · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
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
Merced
California · 49425
Office
Unavailable
Facility
$727.27
No comparable office rate is available.
Modesto
California · 49425
Office
Unavailable
Facility
$727.27
No comparable office rate is available.
Napa
California · 49425
Office
Unavailable
Facility
$796.43
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 49425
Office
Unavailable
Facility
$761.74
No comparable office rate is available.
Redding
California · 49425
Office
Unavailable
Facility
$727.27
No comparable office rate is available.
Rest Of California
California · 49425
Office
Unavailable
Facility
$727.27
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 49425
Office
Unavailable
Facility
$761.34
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 49425
Office
Unavailable
Facility
$751.07
No comparable office rate is available.
Salinas
California · 49425
Office
Unavailable
Facility
$748.11
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 49425
Office
Unavailable
Facility
$757.33
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 49425
Office
Unavailable
Facility
$826.26
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 49425
Office
Unavailable
Facility
$822.65
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 49425
Office
Unavailable
Facility
$848.17
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 49425
Office
Unavailable
Facility
$833.40
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 49425
Office
Unavailable
Facility
$737.70
No comparable office rate is available.
Santa Cruz-Watsonville
California · 49425
Office
Unavailable
Facility
$757.72
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 49425
Office
Unavailable
Facility
$748.62
No comparable office rate is available.
Santa Rosa-Petaluma
California · 49425
Office
Unavailable
Facility
$764.45
No comparable office rate is available.
Stockton
California · 49425
Office
Unavailable
Facility
$727.27
No comparable office rate is available.
Vallejo
California · 49425
Office
Unavailable
Facility
$791.22
No comparable office rate is available.
Visalia
California · 49425
Office
Unavailable
Facility
$727.27
No comparable office rate is available.
Yuba City
California · 49425
Office
Unavailable
Facility
$727.27
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 49425
Office
Unavailable
Facility
$823.16
No comparable office rate is available.
Miami
Florida · 49425
Office
Unavailable
Facility
$918.85
No comparable office rate is available.
Chicago
Illinois · 49425
Office
Unavailable
Facility
$888.06
No comparable office rate is available.
Manhattan
New York · 49425
Office
Unavailable
Facility
$873.49
No comparable office rate is available.
Alaska*
Alaska · 49425
Office
Unavailable
Facility
$913.48
No comparable office rate is available.
Alabama
Alabama · 49425
Office
Unavailable
Facility
$670.10
No comparable office rate is available.
Arkansas
Arkansas · 49425
Office
Unavailable
Facility
$660.80
No comparable office rate is available.
Arizona
Arizona · 49425
Office
Unavailable
Facility
$723.70
No comparable office rate is available.
Colorado
Colorado · 49425
Office
Unavailable
Facility
$743.54
No comparable office rate is available.
Connecticut
Connecticut · 49425
Office
Unavailable
Facility
$795.44
No comparable office rate is available.
Delaware
Delaware · 49425
Office
Unavailable
Facility
$734.86
No comparable office rate is available.
Fort Lauderdale
Florida · 49425
Office
Unavailable
Facility
$835.48
No comparable office rate is available.
Rest Of Florida
Florida · 49425
Office
Unavailable
Facility
$789.27
No comparable office rate is available.
Atlanta
Georgia · 49425
Office
Unavailable
Facility
$772.93
No comparable office rate is available.
Rest Of Georgia
Georgia · 49425
Office
Unavailable
Facility
$740.71
No comparable office rate is available.
Hawaii, Guam
Hawaii · 49425
Office
Unavailable
Facility
$735.01
No comparable office rate is available.
Iowa
Iowa · 49425
Office
Unavailable
Facility
$661.85
No comparable office rate is available.
Idaho
Idaho · 49425
Office
Unavailable
Facility
$671.14
No comparable office rate is available.
East St. Louis
Illinois · 49425
Office
Unavailable
Facility
$834.81
No comparable office rate is available.
Rest Of Illinois
Illinois · 49425
Office
Unavailable
Facility
$785.21
No comparable office rate is available.
Suburban Chicago
Illinois · 49425
Office
Unavailable
Facility
$837.84
No comparable office rate is available.
Indiana
Indiana · 49425
Office
Unavailable
Facility
$674.21
No comparable office rate is available.
Kansas
Kansas · 49425
Office
Unavailable
Facility
$670.55
No comparable office rate is available.
Kentucky
Kentucky · 49425
Office
Unavailable
Facility
$710.57
No comparable office rate is available.
New Orleans
Louisiana · 49425
Office
Unavailable
Facility
$746.65
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 49425
Office
Unavailable
Facility
$714.16
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 49425
Office
Unavailable
Facility
$798.18
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 49425
Office
Unavailable
Facility
$744.17
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 49425
Office
Unavailable
Facility
$795.75
No comparable office rate is available.
Rest Of Maryland
Maryland · 49425
Office
Unavailable
Facility
$744.69
No comparable office rate is available.
Rest Of Maine
Maine · 49425
Office
Unavailable
Facility
$686.96
No comparable office rate is available.
Southern Maine
Maine · 49425
Office
Unavailable
Facility
$705.13
No comparable office rate is available.
Detroit
Michigan · 49425
Office
Unavailable
Facility
$810.89
No comparable office rate is available.
Rest Of Michigan
Michigan · 49425
Office
Unavailable
Facility
$739.12
No comparable office rate is available.
Minnesota
Minnesota · 49425
Office
Unavailable
Facility
$678.77
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 49425
Office
Unavailable
Facility
$729.28
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 49425
Office
Unavailable
Facility
$735.08
No comparable office rate is available.
Rest Of Missouri
Missouri · 49425
Office
Unavailable
Facility
$710.28
No comparable office rate is available.
Mississippi
Mississippi · 49425
Office
Unavailable
Facility
$685.08
No comparable office rate is available.
Montana**
Montana · 49425
Office
Unavailable
Facility
$746.30
No comparable office rate is available.
North Carolina
North Carolina · 49425
Office
Unavailable
Facility
$691.92
No comparable office rate is available.
North Dakota**
North Dakota · 49425
Office
Unavailable
Facility
$683.42
No comparable office rate is available.
Nebraska
Nebraska · 49425
Office
Unavailable
Facility
$661.77
No comparable office rate is available.
New Hampshire
New Hampshire · 49425
Office
Unavailable
Facility
$743.18
No comparable office rate is available.
Northern Nj
New Jersey · 49425
Office
Unavailable
Facility
$817.59
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 49425
Office
Unavailable
Facility
$795.03
No comparable office rate is available.
New Mexico
New Mexico · 49425
Office
Unavailable
Facility
$747.73
No comparable office rate is available.
Nevada**
Nevada · 49425
Office
Unavailable
Facility
$729.01
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 49425
Office
Unavailable
Facility
$908.83
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 49425
Office
Unavailable
Facility
$809.75
No comparable office rate is available.
Queens
New York · 49425
Office
Unavailable
Facility
$863.05
No comparable office rate is available.
Rest Of New York
New York · 49425
Office
Unavailable
Facility
$702.84
No comparable office rate is available.
Ohio
Ohio · 49425
Office
Unavailable
Facility
$726.26
No comparable office rate is available.
Oklahoma
Oklahoma · 49425
Office
Unavailable
Facility
$696.88
No comparable office rate is available.
Portland
Oregon · 49425
Office
Unavailable
Facility
$752.60
No comparable office rate is available.
Rest Of Oregon
Oregon · 49425
Office
Unavailable
Facility
$713.99
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 49425
Office
Unavailable
Facility
$784.11
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 49425
Office
Unavailable
Facility
$720.78
No comparable office rate is available.
Puerto Rico
Puerto Rico · 49425
Office
Unavailable
Facility
$747.58
No comparable office rate is available.
Rhode Island
Rhode Island · 49425
Office
Unavailable
Facility
$750.60
No comparable office rate is available.
South Carolina
South Carolina · 49425
Office
Unavailable
Facility
$712.15
No comparable office rate is available.
South Dakota**
South Dakota · 49425
Office
Unavailable
Facility
$675.98
No comparable office rate is available.
Tennessee
Tennessee · 49425
Office
Unavailable
Facility
$675.27
No comparable office rate is available.
Austin
Texas · 49425
Office
Unavailable
Facility
$749.26
No comparable office rate is available.
Beaumont
Texas · 49425
Office
Unavailable
Facility
$717.14
No comparable office rate is available.
Brazoria
Texas · 49425
Office
Unavailable
Facility
$724.14
No comparable office rate is available.
Dallas
Texas · 49425
Office
Unavailable
Facility
$734.04
No comparable office rate is available.
Fort Worth
Texas · 49425
Office
Unavailable
Facility
$732.99
No comparable office rate is available.
Galveston
Texas · 49425
Office
Unavailable
Facility
$729.73
No comparable office rate is available.
Houston
Texas · 49425
Office
Unavailable
Facility
$787.93
No comparable office rate is available.
Rest Of Texas
Texas · 49425
Office
Unavailable
Facility
$723.84
No comparable office rate is available.
Utah
Utah · 49425
Office
Unavailable
Facility
$721.13
No comparable office rate is available.
Virginia
Virginia · 49425
Office
Unavailable
Facility
$711.16
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 49425
Office
Unavailable
Facility
$747.58
No comparable office rate is available.
Vermont
Vermont · 49425
Office
Unavailable
Facility
$691.62
No comparable office rate is available.
Rest Of Washington
Washington · 49425
Office
Unavailable
Facility
$739.15
No comparable office rate is available.
Seattle (King Cnty)
Washington · 49425
Office
Unavailable
Facility
$802.01
No comparable office rate is available.
Wisconsin
Wisconsin · 49425
Office
Unavailable
Facility
$662.82
No comparable office rate is available.
West Virginia
West Virginia · 49425
Office
Unavailable
Facility
$760.52
No comparable office rate is available.
Wyoming**
Wyoming · 49425
Office
Unavailable
Facility
$718.89
No comparable office rate is available.
See how rates vary across the country
49425 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 49425 in Chico. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$800.00
$727.27 × 110% = $800.00
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.
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 49425 in Chico.
PPRRVU2026_Oct_nonQPP.csv
5,805
- Code
- 49425
- Physician work
- 11.91
- Practice expense
- 7.26
- Malpractice
- 3.18
GPCI2026.csv
9
- Locality
- Chico
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.91 | × 1.017 | 12.1125 |
| Practice expense | 7.26 | × 1.096 | 7.9570 |
| Malpractice | 3.18 | × 0.536 | 1.7045 |
| Total RVUs | 21.7739 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Chico$727.27
Open 49425 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.91 | 1.017 |
| Practice expense | 7.26 | 1.096 |
| Malpractice | 3.18 | 0.536 |
(11.91 × 1.017 + 7.26 × 1.096 + 3.18 × 0.536) × $33.4009 = $727.27
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
49425 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
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 from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $727.27 | RVU26D |
| 2026-07-01 | Not available in this setting | $727.27 | RVU26C |
| 2026-04-01 | Not available in this setting | $727.27 | RVU26B |
| 2026-01-01 | Not available in this setting | $727.27 | RVU26A |
| 2025-10-01 | Not available in this setting | $752.35 | RVU25D |
| 2025-07-01 | Not available in this setting | $752.35 | RVU25C |
| 2025-04-01 | Not available in this setting | $752.35 | RVU25B |
| 2025-01-01 | Not available in this setting | $752.35 | RVU25A |
49425 billing questions
When should 49425 be chosen instead of 49426?
Use 49425 for placement of a new peritoneovenous shunt. Code 49426 describes revision of an existing abdominal-venous shunt.
Does 49425 cover later shunt removal?
No. The insertion service is distinct from removal of an existing shunt, reported with 49429.
How does 49425 differ from tunneled intraperitoneal catheter placement?
A peritoneovenous shunt routes peritoneal fluid into the venous circulation. Code 49418 is for insertion of a tunneled intraperitoneal catheter, not a peritoneovenous shunt.
What documentation supports reporting 49425?
Document the indication, that a new peritoneovenous shunt was placed, and the operative details establishing the shunt connection. The record should make clear that the service was not revision or removal of an existing shunt.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures in that session are paid at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
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.
5,80249422,,Remove tunneled ip cath,A,,3.90,1.18,NA,1.18,,0.96,6.04,6.04,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80349423,,Exchange drainage catheter,A,,1.42,14.87,,0.24,,0.16,16.45,1.82,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80449424,,Assess cyst contrast inject,A,,0.74,4.31,,0.15,,0.07,5.12,0.96,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80549425,,Insert abdomen-venous drain,A,,11.91,7.26,NA,7.26,,3.18,22.35,22.35,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80649426,,Revise abdomen-venous shunt,A,,10.15,6.38,NA,6.38,,2.71,19.24,19.24,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80749427,,Injection abdominal shunt,A,,0.87,0.08,NA,0.08,,0.11,1.06,1.06,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80849428,,Ligation of shunt,A,,6.70,3.84,NA,3.84,,1.78,12.32,12.32,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536