Billing code 49002: Abdominal reoperationMedicare rate & RVUs in Guam
Report reopening a recent abdominal operative incision when the surgeon must return to the abdomen to address a postoperative problem.
CMS doesn’t publish an office rate for 49002 in Guam.
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 49002 covers
The surgeon re-enters the abdomen through a recent operative incision to assess or treat a postoperative problem, such as suspected bleeding or infection. This service is typically performed by a general or other abdominal surgeon in a hospital operating room. It describes a return to the operative site, rather than an initial abdominal exploration in a patient who has not recently undergone laparotomy.
Report the service when the operative note supports reopening the recent incision and describes the reason and work performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is 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.
49002 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $949.54 |
How the 49002 rate is calculated
Each of 49002’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 · 49002
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 17.19Practice expense 7.71Malpractice 4.27
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49002
49002 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49002
Abdominal reoperation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 49002
Abdominal reoperation
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49002 without 51 · national facility
$974.30
Abdominal reoperation
49002-51 · Second procedure: 50%
$487.15
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%).
49002 compared with similar codes
Compare codes
49002 vs 49000 vs 49014 vs 49020: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 49000Abdominal exploration
- 49002 is for returning through a recent abdominal operative incision. 49000 describes abdominal exploration without that recent-operation context.
- 49014Pelvic re-exploration
- Choose 49014 when the re-exploration is specifically of a pelvic wound; 49002 applies to reopening a recent abdominal operative incision.
- 49020Abscess drainage
- 49020 describes open drainage of an abdominal abscess. Use 49002 when the documented service is reopening a recent laparotomy, rather than a focused abscess-drainage procedure.
49002 billing questions
How is this different from 49000?
Use 49002 when the surgeon returns through a recent abdominal operative incision. Use 49000 for an exploratory abdominal operation that is not a reopening of a recent laparotomy.
Can the surgeon report a separate procedure performed after reopening?
A distinct procedure may be reportable when the operative documentation supports work beyond the re-entry itself. If multiple procedures are performed in the same session, CMS applies the standard multiple procedure reduction to the lower-valued procedures.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this service; modifier 50 does not describe reopening an abdominal incision.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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