Both codes describe abdominal paracentesis; choose 49083 when imaging guides the procedure and 49082 when it does not.
On this page
CMS RVU26D · Effective 2026-10-01
49083 Paracentesis Medicare reimbursement rates in Indiana
Report image-guided abdominal paracentesis when a clinician removes peritoneal fluid for diagnosis or symptom relief using imaging to guide needle placement. Compare 49083 office and facility rates across CMS payment localities in Indiana.
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 49083 in Indiana?
Indiana 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
$265.15
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
Facility setting
$87.74
1 of 1 localities have a supported rate.
Payment area: Indiana
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.
Interventional procedure
About 49083: Image-Guided Abdominal Paracentesis
Report image-guided abdominal paracentesis when a clinician removes peritoneal fluid for diagnosis or symptom relief using imaging to guide needle placement.
A clinician uses imaging, commonly ultrasound, to guide a needle or catheter into the peritoneal cavity and remove ascitic fluid. The procedure may obtain fluid for diagnostic testing or relieve symptoms from fluid accumulation, such as abdominal distention or discomfort. It is performed in settings including hospitals, outpatient departments, and offices by physicians or other qualified practitioners who perform paracentesis.
Select 49083 when imaging guidance is used; 49082 is the corresponding code for paracentesis without imaging guidance. Documentation should support the indication, fluid removal, and use of imaging to guide the procedure. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 49083
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.95 · 23%
- Practice expense (office) RVU6.35 · 75%
- Malpractice RVU0.21 · 2%
235.4K
Medicare services in 2024 · #353 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.
49083 compared with similar codes
Office rates for Indiana, from the same CMS release.
49083 removes peritoneal fluid through a needle or catheter. 49084 describes peritoneal lavage rather than routine fluid drainage.
49083 is percutaneous fluid removal from the peritoneal cavity. 49020 describes open drainage of an abdominal abscess.
Compare 49083 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
Indiana →
Office / nonfacility
$265.15
Facility
$87.74
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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 49083 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
5,771
- Code
- 49083
- Physician work
- 1.95
- Practice expense
- 6.35
- Malpractice
- 0.21
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.95 | × 1.000 | 1.9500 |
| Practice expense | 6.35 | × 0.927 | 5.8864 |
| Malpractice | 0.21 | × 0.486 | 0.1021 |
| Total RVUs | 7.9385 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$265.15
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.95 | 1 |
| Practice expense | 6.35 | 0.927 |
| Malpractice | 0.21 | 0.486 |
(1.95 × 1 + 6.35 × 0.927 + 0.21 × 0.486) × $33.4009 = $265.15
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.95 | 1 |
| Practice expense | 0.62 | 0.927 |
| Malpractice | 0.21 | 0.486 |
(1.95 × 1 + 0.62 × 0.927 + 0.21 × 0.486) × $33.4009 = $87.74
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.
49083 billing questions
When should 49083 be selected instead of 49082?
Use 49083 when imaging is used to guide the paracentesis. Use 49082 when the paracentesis is performed without imaging guidance.
Can the imaging guidance be reported separately?
Imaging guidance is part of 49083. Do not separately report a guidance service for the same needle placement.
Can modifier 50 be appended for fluid removed from both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
What documentation supports 49083?
Document the clinical reason for drainage, that peritoneal fluid was removed, and that imaging was used to guide the procedure.
How is 49083 affected when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be billed for this procedure?
Medicare does not pay an assistant at surgery for 49083. 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 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.
