No office rate
49188 is for an open-treated intra-abdominal lesion measuring 10.1-20 cm; this code is for the next size band, 20.1-30 cm.
On this page
CMS RVU26D · Effective 2026-10-01
49189 in Vallejo
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$2239.80
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 49189: Open intra-abdominal lesion excision, 20.1-30 cm
Open abdominal excision or destruction of a 20.1-30 cm intra-abdominal tumor, cyst, or endometrioma is reported when operative treatment targets a lesion in this size band.
This code describes open operative treatment by excision or destruction of a large intra-abdominal tumor, cyst, or endometrioma in the 20.1-30 cm size band. General surgeons, gynecologic surgeons, and surgical oncologists may perform the service in a hospital operating room. The operative report should establish the open approach, the lesion treated, the method of treatment, and its documented size.
Choose this level based on the treated lesion’s size; use a neighboring code when it falls in another size band. The 90-day global period includes 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 50% multiple-procedure reduction. Modifier 50 is not appropriate for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 49189
- 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 RVU39.00 · 61%
- Practice expense (office) RVU16.29 · 25%
- Malpractice RVU9.00 · 14%
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.
49189 compared with similar codes
Office rates for Vallejo, from the same CMS release.
No office rate
49190 applies when the lesion is larger than 30 cm. Use this code for the 20.1-30 cm band.
$204.96
49180 is for biopsy of an abdominal mass. This code describes open excision or destruction, not tissue sampling alone.
$1,561.98
49185 describes sclerotherapy of a fluid collection. This code describes open excision or destruction of an intra-abdominal tumor, cyst, or endometrioma.
The same code, a different location
How does Vallejo compare?
49189 across payment areas
Same release and payment basis · bars start at $0
Vallejo · 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.
Unavailable
No comparable rate is available in this setting.
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
Madera
California · 49189
Office
Unavailable
Facility
$2082.24
No comparable office rate is available.
Merced
California · 49189
Office
Unavailable
Facility
$2082.24
No comparable office rate is available.
Modesto
California · 49189
Office
Unavailable
Facility
$2082.24
No comparable office rate is available.
Napa
California · 49189
Office
Unavailable
Facility
$2254.53
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 49189
Office
Unavailable
Facility
$2169.51
No comparable office rate is available.
Redding
California · 49189
Office
Unavailable
Facility
$2082.24
No comparable office rate is available.
Rest Of California
California · 49189
Office
Unavailable
Facility
$2082.24
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 49189
Office
Unavailable
Facility
$2178.84
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 49189
Office
Unavailable
Facility
$2143.44
No comparable office rate is available.
Salinas
California · 49189
Office
Unavailable
Facility
$2134.76
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 49189
Office
Unavailable
Facility
$2155.39
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 49189
Office
Unavailable
Facility
$2331.55
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 49189
Office
Unavailable
Facility
$2321.33
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 49189
Office
Unavailable
Facility
$2391.64
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 49189
Office
Unavailable
Facility
$2349.86
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 49189
Office
Unavailable
Facility
$2105.64
No comparable office rate is available.
Santa Cruz-Watsonville
California · 49189
Office
Unavailable
Facility
$2152.20
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 49189
Office
Unavailable
Facility
$2134.66
No comparable office rate is available.
Santa Rosa-Petaluma
California · 49189
Office
Unavailable
Facility
$2171.00
No comparable office rate is available.
Stockton
California · 49189
Office
Unavailable
Facility
$2082.24
No comparable office rate is available.
Visalia
California · 49189
Office
Unavailable
Facility
$2082.24
No comparable office rate is available.
Yuba City
California · 49189
Office
Unavailable
Facility
$2082.24
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 49189
Office
Unavailable
Facility
$2348.50
No comparable office rate is available.
Miami
Florida · 49189
Office
Unavailable
Facility
$2629.28
No comparable office rate is available.
Chicago
Illinois · 49189
Office
Unavailable
Facility
$2548.47
No comparable office rate is available.
Manhattan
New York · 49189
Office
Unavailable
Facility
$2495.01
No comparable office rate is available.
Alaska*
Alaska · 49189
Office
Unavailable
Facility
$2699.05
No comparable office rate is available.
Alabama
Alabama · 49189
Office
Unavailable
Facility
$1948.87
No comparable office rate is available.
Arkansas
Arkansas · 49189
Office
Unavailable
Facility
$1924.83
No comparable office rate is available.
Arizona
Arizona · 49189
Office
Unavailable
Facility
$2087.19
No comparable office rate is available.
Colorado
Colorado · 49189
Office
Unavailable
Facility
$2131.96
No comparable office rate is available.
Connecticut
Connecticut · 49189
Office
Unavailable
Facility
$2278.42
No comparable office rate is available.
Delaware
Delaware · 49189
Office
Unavailable
Facility
$2116.97
No comparable office rate is available.
Fort Lauderdale
Florida · 49189
Office
Unavailable
Facility
$2397.31
No comparable office rate is available.
Rest Of Florida
Florida · 49189
Office
Unavailable
Facility
$2274.61
No comparable office rate is available.
Atlanta
Georgia · 49189
Office
Unavailable
Facility
$2220.38
No comparable office rate is available.
Rest Of Georgia
Georgia · 49189
Office
Unavailable
Facility
$2146.30
No comparable office rate is available.
Hawaii, Guam
Hawaii · 49189
Office
Unavailable
Facility
$2095.33
No comparable office rate is available.
Iowa
Iowa · 49189
Office
Unavailable
Facility
$1919.83
No comparable office rate is available.
Idaho
Idaho · 49189
Office
Unavailable
Facility
$1945.40
No comparable office rate is available.
East St. Louis
Illinois · 49189
Office
Unavailable
Facility
$2408.63
No comparable office rate is available.
Rest Of Illinois
Illinois · 49189
Office
Unavailable
Facility
$2269.25
No comparable office rate is available.
Suburban Chicago
Illinois · 49189
Office
Unavailable
Facility
$2403.22
No comparable office rate is available.
Indiana
Indiana · 49189
Office
Unavailable
Facility
$1953.11
No comparable office rate is available.
Kansas
Kansas · 49189
Office
Unavailable
Facility
$1946.01
No comparable office rate is available.
Kentucky
Kentucky · 49189
Office
Unavailable
Facility
$2061.40
No comparable office rate is available.
New Orleans
Louisiana · 49189
Office
Unavailable
Facility
$2156.12
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 49189
Office
Unavailable
Facility
$2072.15
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 49189
Office
Unavailable
Facility
$2273.24
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 49189
Office
Unavailable
Facility
$2136.00
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 49189
Office
Unavailable
Facility
$2279.15
No comparable office rate is available.
Rest Of Maryland
Maryland · 49189
Office
Unavailable
Facility
$2142.25
No comparable office rate is available.
Rest Of Maine
Maine · 49189
Office
Unavailable
Facility
$1990.19
No comparable office rate is available.
Southern Maine
Maine · 49189
Office
Unavailable
Facility
$2031.52
No comparable office rate is available.
Detroit
Michigan · 49189
Office
Unavailable
Facility
$2334.52
No comparable office rate is available.
Rest Of Michigan
Michigan · 49189
Office
Unavailable
Facility
$2138.79
No comparable office rate is available.
Minnesota
Minnesota · 49189
Office
Unavailable
Facility
$1951.49
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 49189
Office
Unavailable
Facility
$2107.24
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 49189
Office
Unavailable
Facility
$2121.83
No comparable office rate is available.
Rest Of Missouri
Missouri · 49189
Office
Unavailable
Facility
$2064.44
No comparable office rate is available.
Mississippi
Mississippi · 49189
Office
Unavailable
Facility
$1993.26
No comparable office rate is available.
Montana**
Montana · 49189
Office
Unavailable
Facility
$2146.74
No comparable office rate is available.
North Carolina
North Carolina · 49189
Office
Unavailable
Facility
$2002.37
No comparable office rate is available.
North Dakota**
North Dakota · 49189
Office
Unavailable
Facility
$1968.78
No comparable office rate is available.
Nebraska
Nebraska · 49189
Office
Unavailable
Facility
$1918.47
No comparable office rate is available.
New Hampshire
New Hampshire · 49189
Office
Unavailable
Facility
$2132.08
No comparable office rate is available.
Northern Nj
New Jersey · 49189
Office
Unavailable
Facility
$2336.91
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 49189
Office
Unavailable
Facility
$2278.67
No comparable office rate is available.
New Mexico
New Mexico · 49189
Office
Unavailable
Facility
$2162.61
No comparable office rate is available.
Nevada**
Nevada · 49189
Office
Unavailable
Facility
$2097.69
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 49189
Office
Unavailable
Facility
$2591.17
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 49189
Office
Unavailable
Facility
$2320.78
No comparable office rate is available.
Queens
New York · 49189
Office
Unavailable
Facility
$2462.61
No comparable office rate is available.
Rest Of New York
New York · 49189
Office
Unavailable
Facility
$2030.86
No comparable office rate is available.
Ohio
Ohio · 49189
Office
Unavailable
Facility
$2102.41
No comparable office rate is available.
Oklahoma
Oklahoma · 49189
Office
Unavailable
Facility
$2022.09
No comparable office rate is available.
Portland
Oregon · 49189
Office
Unavailable
Facility
$2151.63
No comparable office rate is available.
Rest Of Oregon
Oregon · 49189
Office
Unavailable
Facility
$2055.89
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 49189
Office
Unavailable
Facility
$2251.12
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 49189
Office
Unavailable
Facility
$2086.19
No comparable office rate is available.
Puerto Rico
Puerto Rico · 49189
Office
Unavailable
Facility
$2148.82
No comparable office rate is available.
Rhode Island
Rhode Island · 49189
Office
Unavailable
Facility
$2157.58
No comparable office rate is available.
South Carolina
South Carolina · 49189
Office
Unavailable
Facility
$2060.90
No comparable office rate is available.
South Dakota**
South Dakota · 49189
Office
Unavailable
Facility
$1947.74
No comparable office rate is available.
Tennessee
Tennessee · 49189
Office
Unavailable
Facility
$1958.65
No comparable office rate is available.
Austin
Texas · 49189
Office
Unavailable
Facility
$2147.24
No comparable office rate is available.
Beaumont
Texas · 49189
Office
Unavailable
Facility
$2077.03
No comparable office rate is available.
Brazoria
Texas · 49189
Office
Unavailable
Facility
$2086.73
No comparable office rate is available.
Dallas
Texas · 49189
Office
Unavailable
Facility
$2114.20
No comparable office rate is available.
Fort Worth
Texas · 49189
Office
Unavailable
Facility
$2112.67
No comparable office rate is available.
Galveston
Texas · 49189
Office
Unavailable
Facility
$2102.25
No comparable office rate is available.
Houston
Texas · 49189
Office
Unavailable
Facility
$2266.98
No comparable office rate is available.
Rest Of Texas
Texas · 49189
Office
Unavailable
Facility
$2090.44
No comparable office rate is available.
Utah
Utah · 49189
Office
Unavailable
Facility
$2084.04
No comparable office rate is available.
Virginia
Virginia · 49189
Office
Unavailable
Facility
$2049.72
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 49189
Office
Unavailable
Facility
$2148.82
No comparable office rate is available.
Vermont
Vermont · 49189
Office
Unavailable
Facility
$1993.40
No comparable office rate is available.
Rest Of Washington
Washington · 49189
Office
Unavailable
Facility
$2121.27
No comparable office rate is available.
Seattle (King Cnty)
Washington · 49189
Office
Unavailable
Facility
$2280.98
No comparable office rate is available.
Wisconsin
Wisconsin · 49189
Office
Unavailable
Facility
$1916.47
No comparable office rate is available.
West Virginia
West Virginia · 49189
Office
Unavailable
Facility
$2205.63
No comparable office rate is available.
Wyoming**
Wyoming · 49189
Office
Unavailable
Facility
$2069.19
No comparable office rate is available.
See how rates vary across the country
49189 · 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?
Vallejo is a Medicare payment area. Our Census mapping connects it to 11 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 49189 in Vallejo. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$2463.78
$2239.80 × 110% = $2463.78
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 49189 in Vallejo.
PPRRVU2026_Oct_nonQPP.csv
5,778
- Code
- 49189
- Physician work
- 39.00
- Practice expense
- 16.29
- Malpractice
- 9.00
GPCI2026.csv
33
- Locality
- Vallejo
- Physician work
- 1.063
- Practice expense
- 1.318
- Malpractice
- 0.459
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 39.00 | × 1.063 | 41.4570 |
| Practice expense | 16.29 | × 1.318 | 21.4702 |
| Malpractice | 9.00 | × 0.459 | 4.1310 |
| Total RVUs | 67.0582 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vallejo$2239.80
Open 49189 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 39 | 1.063 |
| Practice expense | 16.29 | 1.318 |
| Malpractice | 9 | 0.459 |
(39 × 1.063 + 16.29 × 1.318 + 9 × 0.459) × $33.4009 = $2239.80
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
49189 · 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 | $2239.80 | RVU26D |
| 2026-07-01 | Not available in this setting | $2239.80 | RVU26C |
| 2026-04-01 | Not available in this setting | $2239.80 | RVU26B |
| 2026-01-01 | Not available in this setting | $2239.80 | RVU26A |
| 2025-10-01 | Not available in this setting | $2408.22 | RVU25D |
| 2025-07-01 | Not available in this setting | $2408.22 | RVU25C |
| 2025-04-01 | Not available in this setting | $2408.22 | RVU25B |
| 2025-01-01 | Not available in this setting | $2408.22 | RVU25A |
49189 billing questions
How is this code distinguished from 49188 or 49190?
Use this code when the treated lesion measures 20.1-30 cm. Code 49188 covers the smaller 10.1-20 cm band, while 49190 is for lesions larger than 30 cm.
Can 49180 be reported for the same lesion?
49180 describes biopsy of an abdominal mass, while this code describes open excision or destruction. Report both only when the record supports distinct services rather than treating the same operative work as both sampling and definitive treatment.
Should modifier 50 be appended for bilateral disease?
No. The code’s descriptor and anatomy do not support modifier 50.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports the size-level selection?
Document the open approach, the tumor, cyst, or endometrioma treated, the treatment performed, and the lesion’s size supporting the 20.1-30 cm band.
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 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.
5,77549186,,Opn exc/dstr ntra-abd 5 cm/<,A,,21.45,10.28,NA,10.28,,4.84,36.57,36.57,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77649187,,Opn exc/dstr ntra-abd 5.1-10,A,,27.93,11.95,NA,11.95,,6.42,46.30,46.30,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77749188,,Opn exc/dst ntra-abd 10.1-20,A,,33.15,14.67,NA,14.67,,7.64,55.46,55.46,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77849189,,Opn exc/dst ntra-abd 20.1-30,A,,39.00,16.29,NA,16.29,,9.00,64.29,64.29,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77949190,,Opn exc/dstr ntra-abd >30 cm,A,,48.75,19.26,NA,19.26,,11.04,79.05,79.05,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78049215,,Excise sacral spine tumor,A,,36.86,15.04,NA,15.04,,8.08,59.98,59.98,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78149250,,Excision of umbilicus,A,,8.78,6.13,NA,6.13,,2.10,17.01,17.01,0,090,0.09,0.81,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3001182,CA,74,SANTA MARIA-SANTA BARBARA,1.028,1.166,0.536
3101112,CA,67,SANTA ROSA-PETALUMA,1.030,1.228,0.536
3201112,CA,68,STOCKTON,1.017,1.096,0.536
3301112,CA,53,VALLEJO,1.063,1.318,0.459
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536