$617.56
49460 secures an existing gastrostomy or cecostomy tube with a fixation device; 49450 is for replacing the tube.
On this page
CMS RVU26D · Effective 2026-10-01
49460 Tube fixation Medicare reimbursement rates in Alaska
Percutaneous fixation secures an existing gastrostomy or cecostomy tube with a device when the tube needs stabilization rather than replacement. Compare 49460 office and facility rates across CMS payment localities in Alaska.
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.
What does Medicare pay for 49460 in Alaska?
Alaska has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$771.77
1 of 1 localities have a supported rate.
Payment area: Alaska*
One mapped payment locality.
Facility setting
$57.13
1 of 1 localities have a supported rate.
Payment area: Alaska*
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Image-guided procedures
About 49460: Percutaneous gastrostomy or cecostomy tube fixation
Percutaneous fixation secures an existing gastrostomy or cecostomy tube with a device when the tube needs stabilization rather than replacement.
This service uses a fixation device to secure an existing gastrostomy or cecostomy tube. It is distinct from placing a new feeding or drainage tube and from exchanging a tube that needs replacement. The procedure may be performed by an interventional radiologist or another physician who manages percutaneous access, typically in a procedural setting, when the tube needs mechanical stabilization.
Report the service when the physician performs the fixation, not merely when staff reinforce an external dressing or check tube position. Documentation should identify the existing tube, the reason fixation is needed, the device used, and the work performed. This minor procedure 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 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 49460
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU0.94 · 4%
- Practice expense (office) RVU20.31 · 95%
- Malpractice RVU0.12 · 1%
2.7K
Medicare services in 2024 · #2247 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.
49460 compared with similar codes
Office rates for Alaska, from the same CMS release.
$146.06
49465 is a radiologic evaluation of an existing gastrostomy, duodenostomy, jejunostomy, or cecostomy tube. It evaluates the tube rather than fixing it.
$887.76
49440 covers percutaneous placement of a gastrostomy tube. Choose 49460 when the service fixes an existing gastrostomy tube instead of placing a new one.
$836.69
49442 covers percutaneous placement of a cecostomy tube. Choose 49460 for fixation of an existing cecostomy tube.
Compare 49460 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alaska* →
Office / nonfacility
$771.77
Facility
$57.13
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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 49460 in Alaska*.
PPRRVU2026_Oct_nonQPP.csv
5,819
- Code
- 49460
- Physician work
- 0.94
- Practice expense
- 20.31
- Malpractice
- 0.12
GPCI2026.csv
5
- Locality
- Alaska*
- Physician work
- 1.500
- Practice expense
- 1.065
- Malpractice
- 0.551
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.94 | × 1.500 | 1.4100 |
| Practice expense | 20.31 | × 1.065 | 21.6301 |
| Malpractice | 0.12 | × 0.551 | 0.0661 |
| Total RVUs | 23.1063 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alaska*$771.77
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.94 | 1.5 |
| Practice expense | 20.31 | 1.065 |
| Malpractice | 0.12 | 0.551 |
(0.94 × 1.5 + 20.31 × 1.065 + 0.12 × 0.551) × $33.4009 = $771.77
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.94 | 1.5 |
| Practice expense | 0.22 | 1.065 |
| Malpractice | 0.12 | 0.551 |
(0.94 × 1.5 + 0.22 × 1.065 + 0.12 × 0.551) × $33.4009 = $57.13
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.
49460 billing questions
When should 49460 be used instead of 49450?
Use 49460 for fixation of an existing gastrostomy or cecostomy tube with a device. Use 49450 when the service is replacement of a gastrostomy or cecostomy tube.
Does 49460 include the fixation device?
The service is fixation with a device. The record should identify the device and document the fixation work performed.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
Is same-day follow-up care separately payable?
No. The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction.
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.
5,81649450,,Replace g/c tube perc,A,,1.33,15.41,,0.21,,0.15,16.89,1.69,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81749451,,Replace duod/jej tube perc,A,,1.79,16.02,,0.28,,0.21,18.02,2.28,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81849452,,Replace g-j tube perc,A,,2.79,18.69,,0.41,,0.30,21.78,3.50,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81949460,,Fix g/colon tube w/device,A,,0.94,20.31,,0.22,,0.12,21.37,1.28,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,82049465,,Fluoro exam of g/colon tube,A,,0.60,3.23,,0.11,,0.06,3.89,0.77,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,82149491,,Rpr hern preemie reduc,A,,12.22,7.39,NA,7.39,,3.26,22.87,22.87,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,82249492,,Rpr ing hern premie blocked,A,,15.04,8.22,NA,8.22,,4.02,27.28,27.28,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
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