No office rate
Use 49320 for diagnostic laparoscopic inspection when no biopsy is performed. When the surgeon obtains tissue, 49321 describes the biopsy service.
On this page
CMS RVU26D · Effective 2026-10-01
49321 Laparoscopic biopsy Medicare reimbursement rates in Delaware
Report this service when a surgeon uses laparoscopy to obtain abdominal or pelvic tissue for examination, rather than aspirating fluid or draining a collection. Compare 49321 office and facility rates across CMS payment localities in Delaware.
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 49321 in Delaware?
Delaware 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
$324.64
1 of 1 localities have a supported rate.
Payment area: Delaware
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.
Laparoscopic surgery
About 49321: Laparoscopic abdominal tissue biopsy
Report this service when a surgeon uses laparoscopy to obtain abdominal or pelvic tissue for examination, rather than aspirating fluid or draining a collection.
The surgeon uses a laparoscope and operative instruments to remove one or more tissue samples from an abdominal or pelvic site for histologic evaluation. Common targets include a peritoneal or omental lesion or an accessible abdominal mass. The procedure is generally performed in a hospital or ambulatory surgery facility by a general surgeon or another surgeon treating the suspected disease; a gynecologic surgeon may perform it when the target is in the pelvis.
Choose this code when tissue is obtained, not when the laparoscopic service only inspects the cavity, aspirates fluid, or drains a collection. The operative report should identify the biopsy site and document tissue removal; the pathology service is separately identified when performed and billed. CMS assigns a 10-day global period, including related postoperative visits during that period. Endoscopy-family pricing applies when related endoscopies are performed together. Modifier 50 is inappropriate for this descriptor and anatomy. CMS permits assistant-at-surgery and co-surgeon payment; team-surgery payment is not permitted.
CMS billing rules for 49321
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.30 · 54%
- Practice expense (office) RVU3.30 · 33%
- Malpractice RVU1.26 · 13%
5.1K
Medicare services in 2024 · #1861 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.
49321 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Use 49322 for laparoscopic aspiration, such as removing fluid from a cyst or cavity. Use 49321 when the surgeon removes tissue for histologic evaluation.
No office rate
49323 describes laparoscopic drainage of a lymphocele; 49321 is for obtaining tissue samples, not draining the collection.
Compare 49321 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
Delaware →
Office / nonfacility
Unavailable
Facility
$324.64
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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 49321 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
5,784
- Code
- 49321
- Physician work
- 5.30
- Practice expense
- 3.30
- Malpractice
- 1.26
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.30 | × 1.005 | 5.3265 |
| Practice expense | 3.30 | × 0.988 | 3.2604 |
| Malpractice | 1.26 | × 0.899 | 1.1327 |
| Total RVUs | 9.7196 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$324.64
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.3 | 1.005 |
| Practice expense | 3.3 | 0.988 |
| Malpractice | 1.26 | 0.899 |
(5.3 × 1.005 + 3.3 × 0.988 + 1.26 × 0.899) × $33.4009 = $324.64
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.
49321 billing questions
When should I report 49321 instead of 49320?
Report 49321 when the surgeon obtains tissue during the laparoscopic procedure. Code 49320 describes diagnostic laparoscopic inspection without the biopsy service.
Can I report the diagnostic laparoscopy separately with the biopsy?
Do not separately report 49320 just for the inspection used to identify or reach the biopsy target. The diagnostic code describes inspection, while 49321 describes laparoscopic tissue sampling.
Is modifier 50 appropriate when biopsies are taken on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy; do not use modifier 50 for bilateral biopsy sites.
How are assistant and co-surgeon services handled?
CMS permits payment for an assistant at surgery and for co-surgeons. Team-surgery payment is not permitted for this code.
What postoperative care is included?
The 10-day global period includes related postoperative visits during the 10 days after the procedure.
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.
5,78149250,,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
5,78249255,,Removal of omentum,A,,12.25,7.40,NA,7.40,,2.86,22.51,22.51,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78349320,,Diag laparo separate proc,A,,5.01,3.23,NA,3.23,,1.23,9.47,9.47,0,010,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78449321,,Laparoscopy biopsy,A,,5.30,3.30,NA,3.30,,1.26,9.86,9.86,0,010,0.10,0.80,0.10,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
5,78549322,,Laparoscopy aspiration,A,,5.86,3.36,NA,3.36,,1.42,10.64,10.64,0,010,0.10,0.80,0.10,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
5,78649323,,Laparo drain lymphocele,A,,9.97,5.79,NA,5.79,,2.33,18.09,18.09,0,090,0.10,0.80,0.10,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
5,78749324,,Lap insert tunnel ip cath,A,,6.16,3.19,NA,3.19,,1.61,10.96,10.96,0,010,0.10,0.80,0.10,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503