No office rate
Choose ligation when the shunt is closed off but left in place. Choose 49429 when the shunt itself is removed.
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CMS RVU26D · Effective 2026-10-01
49429 Shunt removal Medicare reimbursement rates in Arkansas
Removal of an existing peritoneovenous shunt, commonly performed when a shunt used to manage refractory ascites must be taken out. Compare 49429 office and facility rates across CMS payment localities in Arkansas.
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 49429 in Arkansas?
Arkansas 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
No supported rate
Facility setting
$385.13
1 of 1 localities have a supported rate.
Payment area: Arkansas
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.
Abdominal surgery
About 49429: Peritoneovenous shunt removal
Removal of an existing peritoneovenous shunt, commonly performed when a shunt used to manage refractory ascites must be taken out.
This service removes a peritoneovenous shunt that carries fluid from the abdominal cavity into the venous circulation. It may be performed when the device is no longer needed or requires removal; the operative note should identify the shunt and document the removal performed. A surgeon typically carries out the procedure in a hospital operating room or another surgical setting. It is distinct from simply closing off the shunt while leaving it in place.
Report this code for removal, not for shunt insertion, revision, or ligation alone. Documentation should support that the shunt was removed and describe the work performed. Medicare assigns a 10-day global period, including related postoperative visits during that period. 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% reduction. Modifier 50 is inappropriate for this anatomy. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 49429
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.25 · 56%
- Practice expense (office) RVU3.82 · 29%
- Malpractice RVU1.94 · 15%
20
Medicare services in 2024 · #5924 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.
49429 compared with similar codes
Office rates for Arkansas, from the same CMS release.
No office rate
This code is for shunt revision; 49429 is for removal rather than repair or alteration of the shunt.
No office rate
This code concerns removal of a tunneled intraperitoneal catheter. Code 49429 concerns removal of a peritoneovenous shunt.
Compare 49429 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
Arkansas →
Office / nonfacility
Unavailable
Facility
$385.13
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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 49429 in Arkansas.
PPRRVU2026_Oct_nonQPP.csv
5,809
- Code
- 49429
- Physician work
- 7.25
- Practice expense
- 3.82
- Malpractice
- 1.94
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.25 | × 1.000 | 7.2500 |
| Practice expense | 3.82 | × 0.859 | 3.2814 |
| Malpractice | 1.94 | × 0.515 | 0.9991 |
| Total RVUs | 11.5305 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arkansas$385.13
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.25 | 1 |
| Practice expense | 3.82 | 0.859 |
| Malpractice | 1.94 | 0.515 |
(7.25 × 1 + 3.82 × 0.859 + 1.94 × 0.515) × $33.4009 = $385.13
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.
49429 billing questions
How is shunt removal different from shunt ligation?
Removal takes the shunt out. Ligation stops flow by closing the shunt while leaving it in place.
Can this code be used for revision of a peritoneovenous shunt?
No. Use the revision code when the shunt is revised rather than removed.
Is modifier 50 appropriate if both sides are involved?
No. The anatomy and service do not support bilateral adjustment with modifier 50.
Are related postoperative visits included?
Yes. The 10-day global period includes related postoperative visits during those 10 days.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code, and co-surgeons are not permitted.
What happens when other procedures are 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.
5,80649426,,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
5,80949429,,Removal of shunt,A,,7.25,3.82,NA,3.82,,1.94,13.01,13.01,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81049435,,Insert subq exten to ip cath,A,,2.19,0.41,NA,0.41,,0.57,3.17,3.17,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81149436,,Embedded ip cath exit-site,A,,2.65,13.51,,1.99,,0.68,16.84,5.32,0,010,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81249440,,Place gastrostomy tube perc,A,,3.83,19.34,,1.08,,0.43,23.60,5.34,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541