No office rate
49435 describes insertion of a subcutaneous extension to an existing peritoneal dialysis catheter. Use 49436 when the work is surgical exposure and revision of the catheter exit site.
On this page
CMS RVU26D · Effective 2026-10-01
49436 Catheter revision Medicare reimbursement rates in Indiana
Revision of a peritoneal dialysis catheter involving surgical exposure of its exit site, including treatment of an embedded catheter or correction of malposition. Compare 49436 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 49436 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
$517.86
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
Facility setting
$161.17
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.
Dialysis access surgery
About 49436: Peritoneal dialysis catheter exit-site revision
Revision of a peritoneal dialysis catheter involving surgical exposure of its exit site, including treatment of an embedded catheter or correction of malposition.
This service involves surgically exposing the exit site of an existing peritoneal dialysis catheter to revise it, such as freeing an embedded catheter or correcting its position. It is typically performed by a surgeon caring for patients whose catheter needs operative revision before or during use for peritoneal dialysis. The operative report should establish the existing catheter, the reason for revision, and the exposure and corrective work performed.
Report this code for the exit-site revision rather than for placement of a new catheter or removal alone. Document the catheter’s condition and the steps taken to expose and revise it. CMS assigns a 10-day global period, so related postoperative visits during that period are included. 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 multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 49436
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU2.65 · 16%
- Practice expense (office) RVU13.51 · 80%
- Malpractice RVU0.68 · 4%
292
Medicare services in 2024 · #4013 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.
49436 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
49421 is for open insertion of a tunneled intraperitoneal catheter. This code is for revision involving surgical exposure of an existing catheter’s exit site.
$873.91
49418 describes percutaneous insertion of a tunneled intraperitoneal catheter; it does not describe surgical exposure and revision of an existing catheter exit site.
No office rate
49422 describes removal of a tunneled intraperitoneal catheter. Use this code when the service is exit-site revision rather than removal alone.
Compare 49436 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
$517.86
Facility
$161.17
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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 49436 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
5,811
- Code
- 49436
- Physician work
- 2.65
- Practice expense
- 13.51
- Malpractice
- 0.68
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.65 | × 1.000 | 2.6500 |
| Practice expense | 13.51 | × 0.927 | 12.5238 |
| Malpractice | 0.68 | × 0.486 | 0.3305 |
| Total RVUs | 15.5043 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$517.86
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.65 | 1 |
| Practice expense | 13.51 | 0.927 |
| Malpractice | 0.68 | 0.486 |
(2.65 × 1 + 13.51 × 0.927 + 0.68 × 0.486) × $33.4009 = $517.86
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.65 | 1 |
| Practice expense | 1.99 | 0.927 |
| Malpractice | 0.68 | 0.486 |
(2.65 × 1 + 1.99 × 0.927 + 0.68 × 0.486) × $33.4009 = $161.17
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.
49436 billing questions
When should I report this instead of a new-catheter insertion code?
Report this service when the surgeon exposes and revises an existing catheter exit site, such as to free an embedded catheter or correct malposition. A new catheter insertion is a different service.
Is this code appropriate for an embedded peritoneal dialysis catheter?
Yes, when the embedded catheter is surgically exposed as part of the revision. The operative note should describe the exposure and any corrective work.
Are related postoperative visits separately reportable?
Related postoperative visits during the 10-day global period are included in this procedure’s payment.
Can I append modifier 50 for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation.
What documentation supports reporting this service?
Document the existing peritoneal dialysis catheter, why revision was needed, surgical exposure of the exit site, and the revision performed, such as freeing an embedded catheter or correcting its position.
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.
5,80849428,,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
5,80949429,,Removal of shunt,A,,7.25,3.82,NA,3.82,,1.94,13.01,13.01,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81049435,,Insert subq exten to ip cath,A,,2.19,0.41,NA,0.41,,0.57,3.17,3.17,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81149436,,Embedded ip cath exit-site,A,,2.65,13.51,,1.99,,0.68,16.84,5.32,0,010,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81249440,,Place gastrostomy tube perc,A,,3.83,19.34,,1.08,,0.43,23.60,5.34,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81349441,,Place duod/jej tube perc,A,,4.41,24.27,,1.39,,0.71,29.39,6.51,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81449442,,Place cecostomy tube perc,A,,3.66,18.18,,1.32,,0.36,22.20,5.34,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915