Billing code 49180: Mass biopsyMedicare rate & RVUs in Florida
Reports percutaneous tissue sampling of an abdominal mass for pathologic evaluation, rather than open removal or treatment of the mass.
Medicare pays $168.62–$183.96 for 49180 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 49180 covers
A clinician obtains tissue from an abdominal mass through the skin, commonly using a needle and imaging to target a lesion that cannot be sampled safely by direct examination. Interventional radiologists and other qualified physicians perform this procedure in hospital and outpatient settings. The specimen is sent for pathologic examination; this code describes sampling, not removal of the mass.
Select the code when the target is an abdominal mass and the approach is percutaneous. The procedure note should identify the target, approach, tissue obtained, and any imaging guidance performed. Report imaging guidance separately when appropriate. The 0-day global period includes same-day preoperative and postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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.
Where 49180 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$168.62 to $183.96
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $176.60 | $76.11 |
| Miami | $183.96 | $80.69 |
| Rest Of Florida | $168.62 | $73.79 |
How the 49180 rate is calculated
Each of 49180’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 · 49180
RVUs × geographic indexes × conversion factor
Work1.69
1.69 RVUs× 1.000 GPCI
Practice expense3.23
3.23 RVUs× 1.000 GPCI
Malpractice0.18
0.18 RVUs× 1.000 GPCI
Adjusted RVUs
5.1000
Conversion factor
$33.4009
Medicare rate
$170.34
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49180
The CMS indicators that decide how 49180 is paid alongside other services.
CMS payment indicators · 49180
Mass biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49180 without 51 · national office
$170.34
Mass biopsy
49180-51 · Second procedure: 50%
$85.17
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%).
49180 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 47000Liver biopsy
- This code is for percutaneous biopsy of an abdominal mass; 47000 is specific to biopsy of the liver.
- 49185Fluid collection treatment
- 49180 samples tissue from a mass. 49185 treats a fluid collection with sclerotherapy.
- 49186Open lesion removal
- 49180 describes percutaneous diagnostic sampling; 49186 describes open excision or destruction of a small intra-abdominal tumor.
49180 billing questions
When is 49180 appropriate instead of an organ-specific biopsy code?
Use 49180 for percutaneous sampling of an abdominal mass when the target is not better represented by a site-specific biopsy code. For a liver target, consider the liver biopsy code 47000.
Is imaging guidance included?
When CT or ultrasound guidance is performed, report the applicable guidance service separately when appropriate. The record should support the guidance method and its use to direct needle placement.
Does the code include removal of the entire mass?
No. It represents percutaneous tissue sampling for diagnosis, not open excision or destruction of an intra-abdominal tumor.
What is included in the 0-day global period?
Same-day preoperative and postoperative care is included. The global period does not extend beyond the day of the procedure.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 49180. Co-surgeon and team-surgery billing are not permitted.
How does the multiple-procedure reduction affect the claim?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% 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 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
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