CPT code 49441: Enteral tube placement2026 Medicare rate & RVUs in Delaware

Reports image-guided percutaneous placement of an enteral tube into the duodenum or jejunum when postpyloric feeding access is needed.

CMS RVU26DEffective Oct 1, 20261 payment locality410 Medicare services in 2024

Medicare pays $970.27 for 49441 in the office in Delaware (Delaware). Which amount applies depends on the service address.

$970.27Office (non-facility)
$215.22Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 49441 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Delaware
  2. What 49441 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 49441 covers

This service establishes enteral access to the duodenum or jejunum through a percutaneous approach, using fluoroscopic guidance to position the tube and confirm its location. It is typically performed by an interventional radiologist in a hospital setting when a patient needs small-bowel feeding access rather than feeding into the stomach. Fluoroscopic guidance, contrast injections, and the related radiological supervision and interpretation are part of the placement service.

Report 49441 for new percutaneous duodenal or jejunal tube placement, not for exchanging an existing tube or converting a gastrostomy tube to a gastrojejunostomy tube. The procedure report should support the access site, tube destination, placement technique, and imaging confirmation. CMS assigns a 10-day global period, so related postoperative visits during that period are 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.

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.

49441 in Delaware

49441 office and facility rates by payment locality
Payment localityOfficeFacility
Delaware$970.27$215.22

How the 49441 rate is calculated

Each of 49441’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 49441

RVUs × geographic indexes × conversion factor

Work4.41

4.41 RVUs× 1.000 GPCI

Practice expense24.27

24.27 RVUs× 1.000 GPCI

Malpractice0.71

0.71 RVUs× 1.000 GPCI

Adjusted RVUs

29.3900

Conversion factor

$33.4009

Medicare rate

$981.65

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 49441

49441 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 49441

Enteral tube placement

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 49441

Enteral tube placement

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49441 without 51 · national office

$981.65

Enteral tube placement

49441-51 · Second procedure: 50%

$490.83

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

49441 compared with similar codes

Compare codes · National

5 codes, side by side

  • 49441

    Enteral tube placement4.41 wRVU

    $981.65

  • 49440

    Gastrostomy placement3.83 wRVU

    $788.26−$193.39

  • 49442

    Cecostomy tube3.66 wRVU

    $741.50−$240.15

  • 49446

    Tube conversion2.98 wRVU

    $763.54−$218.11

  • 49451

    Feeding tube exchange1.79 wRVU

    $601.88−$379.77

How to choose

49440Gastrostomy placement
Choose 49440 for new percutaneous tube placement into the stomach. Choose 49441 when the tube is placed into the duodenum or jejunum.
49442Cecostomy tube
49442 places a tube into the cecum; 49441 places enteral access into the duodenum or jejunum.
49446Tube conversion
49446 converts an existing gastrostomy tube to a gastrojejunostomy tube. 49441 reports new percutaneous duodenal or jejunal tube placement.
49451Feeding tube exchange
49451 is for percutaneous replacement of an existing duodenal or jejunal tube. Use 49441 for new placement.

49441 billing questions

How does 49441 differ from 49440?

49441 establishes percutaneous tube access to the duodenum or jejunum. Use 49440 when the tube is placed into the stomach.

Can fluoroscopic guidance and contrast be billed separately?

The placement service includes fluoroscopic guidance, contrast injections, and the related radiological supervision and interpretation.

Is 49441 used to replace an existing duodenal or jejunal tube?

No. Report 49441 for new placement; 49451 describes percutaneous replacement of a duodenal or jejunal tube.

What postoperative care is included?

Related postoperative visits for 10 days are included in the global period.

Can modifier 50 be used, or can an assistant surgeon be paid?

Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 49441PPRRVU2026_Oct_nonQPP.csv, line 5,813 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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