No office rate
49425 is for placing a new peritoneovenous shunt. Choose 49426 when the operative service revises an existing shunt.
On this page
CMS RVU26D · Effective 2026-10-01
49425 Abdominal shunt Medicare reimbursement rates in Idaho
Reports surgical placement of a peritoneovenous shunt to move ascitic fluid from the abdominal cavity into the venous circulation. Compare 49425 office and facility rates across CMS payment localities in Idaho.
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 49425 in Idaho?
Idaho 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
$671.14
1 of 1 localities have a supported rate.
Payment area: Idaho
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 49425: Peritoneovenous shunt insertion
Reports surgical placement of a peritoneovenous shunt to move ascitic fluid from the abdominal cavity into the venous circulation.
This service places a shunt connecting the peritoneal cavity with the venous system, allowing ascitic fluid to flow into the circulation. It is generally performed by a surgeon in a hospital operating room for a patient with ascites when peritoneovenous diversion is selected. The operative record should identify the indication and document creation of the abdominal-to-venous shunt pathway and its placement.
Report 49425 for the shunt insertion itself, not for later revision, evaluation, ligation, or removal. Documentation should distinguish new placement from work on an existing shunt. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 49425
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.91 · 53%
- Practice expense (office) RVU7.26 · 32%
- Malpractice RVU3.18 · 14%
37
Medicare services in 2024 · #5539 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.
49425 compared with similar codes
Office rates for Idaho, from the same CMS release.
No office rate
49429 reports removal of an existing abdominal-venous shunt; it does not describe initial shunt placement.
$868.15
49418 describes insertion of a tunneled intraperitoneal catheter. It does not create the peritoneal-to-venous shunt reported with 49425.
$774.83
49405 describes image-guided catheter drainage of a visceral fluid collection, rather than surgical placement of a peritoneovenous shunt.
Compare 49425 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
Idaho →
Office / nonfacility
Unavailable
Facility
$671.14
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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 49425 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
5,805
- Code
- 49425
- Physician work
- 11.91
- Practice expense
- 7.26
- Malpractice
- 3.18
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.91 | × 1.000 | 11.9100 |
| Practice expense | 7.26 | × 0.920 | 6.6792 |
| Malpractice | 3.18 | × 0.473 | 1.5041 |
| Total RVUs | 20.0933 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$671.14
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.91 | 1 |
| Practice expense | 7.26 | 0.92 |
| Malpractice | 3.18 | 0.473 |
(11.91 × 1 + 7.26 × 0.92 + 3.18 × 0.473) × $33.4009 = $671.14
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.
49425 billing questions
When should 49425 be chosen instead of 49426?
Use 49425 for placement of a new peritoneovenous shunt. Code 49426 describes revision of an existing abdominal-venous shunt.
Does 49425 cover later shunt removal?
No. The insertion service is distinct from removal of an existing shunt, reported with 49429.
How does 49425 differ from tunneled intraperitoneal catheter placement?
A peritoneovenous shunt routes peritoneal fluid into the venous circulation. Code 49418 is for insertion of a tunneled intraperitoneal catheter, not a peritoneovenous shunt.
What documentation supports reporting 49425?
Document the indication, that a new peritoneovenous shunt was placed, and the operative details establishing the shunt connection. The record should make clear that the service was not revision or removal of an existing shunt.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures in that session are paid at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
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.
5,80249422,,Remove tunneled ip cath,A,,3.90,1.18,NA,1.18,,0.96,6.04,6.04,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80349423,,Exchange drainage catheter,A,,1.42,14.87,,0.24,,0.16,16.45,1.82,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80449424,,Assess cyst contrast inject,A,,0.74,4.31,,0.15,,0.07,5.12,0.96,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80549425,,Insert abdomen-venous drain,A,,11.91,7.26,NA,7.26,,3.18,22.35,22.35,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80649426,,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
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772