No office rate
Choose 49905 when the omental flap remains within the abdominal cavity; 49904 describes an extra-abdominal flap.
On this page
CMS RVU26D · Effective 2026-10-01
49905 Omental flap Medicare reimbursement rates in Indiana
Reports additional surgical work to mobilize and position omentum within the abdomen as a flap during a qualifying primary abdominal procedure. Compare 49905 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 49905 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
No supported rate
Facility setting
$285.73
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.
General surgery
About 49905: Intra-abdominal omental flap
Reports additional surgical work to mobilize and position omentum within the abdomen as a flap during a qualifying primary abdominal procedure.
49905 captures the surgeon’s additional work of mobilizing and positioning omental tissue as a flap that remains inside the abdominal cavity, such as to cover or reinforce an intra-abdominal defect or support repair of an intra-abdominal fistula. It is performed during an abdominal operation, typically by a general or colorectal surgeon in an operating room.
Report 49905 only with a qualifying primary procedure; it is not a standalone service. Select it when the flap is placed intra-abdominally, rather than carried outside the abdomen or transferred as a free flap with microvascular anastomosis. The operative report should identify the omentum used, its mobilization and final placement, the target or defect addressed, and the primary operation. CMS classifies 49905 as an add-on code and pays it within the primary procedure’s global period.
CMS billing rules for 49905
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU6.38 · 68%
- Practice expense (office) RVU1.57 · 17%
- Malpractice RVU1.48 · 16%
7.7K
Medicare services in 2024 · #1606 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.
49905 compared with similar codes
Office rates for Indiana, from the same CMS release.
49906
No office rateFree omental flap microvasc
49906 describes a free omental flap transferred with microvascular anastomosis, rather than an intra-abdominal flap placement.
49999
No office rateUnlisted px abd pertm&omn
Use 49905 when its listed intra-abdominal flap service fits; 49999 is for an abdominal procedure without a specific listed code.
Compare 49905 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
Unavailable
Facility
$285.73
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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 49905 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
5,862
- Code
- 49905
- Physician work
- 6.38
- Practice expense
- 1.57
- Malpractice
- 1.48
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.38 | × 1.000 | 6.3800 |
| Practice expense | 1.57 | × 0.927 | 1.4554 |
| Malpractice | 1.48 | × 0.486 | 0.7193 |
| Total RVUs | 8.5547 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$285.73
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.38 | 1 |
| Practice expense | 1.57 | 0.927 |
| Malpractice | 1.48 | 0.486 |
(6.38 × 1 + 1.57 × 0.927 + 1.48 × 0.486) × $33.4009 = $285.73
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.
49905 billing questions
Can 49905 be reported by itself?
No. It is an add-on code and must be billed with a primary procedure.
How does 49905 differ from 49904?
49905 is for an omental flap placed within the abdomen. 49904 describes an extra-abdominal flap.
When is 49906 a better fit?
Use 49906 for a free omental flap transferred with microvascular anastomosis. 49905 describes an intra-abdominal flap.
What should the operative report document?
Document the omentum mobilized, its intra-abdominal destination, the defect or target addressed, and the primary procedure performed.
What is the global-period treatment for 49905?
CMS treats 49905 as an add-on paid within the primary procedure’s global period.
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.
5,85949659,,Unlstd laps px hrnap hrnrphy,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86049900,,Repair of abdominal wall,A,,12.10,8.82,NA,8.82,,3.04,23.96,23.96,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86149904,,Omental flap extra-abdom,A,,21.79,11.77,NA,11.77,,5.01,38.57,38.57,0,090,0.10,0.80,0.10,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86249905,,Omental flap intra-abdom,A,,6.38,1.57,NA,1.57,,1.48,9.43,9.43,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86349906,,Free omental flap microvasc,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,090,0.09,0.81,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86449999,,Unlisted px abd pertm&omn,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86550010,,Renal exploration,A,,11.97,5.70,NA,5.70,,1.53,19.20,19.20,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,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