No office rate
49421 reports open insertion of the tunneled intraperitoneal catheter; 49435 adds the subcutaneous extension and is reported with that primary procedure.
On this page
CMS RVU26D · Effective 2026-10-01
49435 Catheter extension Medicare reimbursement rates in Kansas
Reports tunneling and placement of a subcutaneous extension on an intraperitoneal dialysis catheter, such as to create a presternal exit site. Compare 49435 office and facility rates across CMS payment localities in Kansas.
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 49435 in Kansas?
Kansas 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
$95.12
1 of 1 localities have a supported rate.
Payment area: Kansas
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
About 49435: Subcutaneous peritoneal catheter extension
Reports tunneling and placement of a subcutaneous extension on an intraperitoneal dialysis catheter, such as to create a presternal exit site.
This service adds a subcutaneous segment to an intraperitoneal catheter and tunnels it to a new exit site, such as the chest for a presternal configuration. It is performed by a surgeon or another clinician who places peritoneal dialysis access, typically in an operative setting. The extension changes where the catheter exits the skin; it is not a service for inserting an entirely new intraperitoneal catheter.
Report 49435 as an add-on with the qualifying open catheter insertion, 49421. The record should identify the existing or concurrently placed catheter, the extension, the tunneling performed, and the intended exit-site location. Do not report it alone or pair it with a different primary insertion code. CMS pays this add-on within the global period of the primary procedure, so it is included in that procedure’s global-period payment.
CMS billing rules for 49435
- 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 RVU2.19 · 69%
- Practice expense (office) RVU0.41 · 13%
- Malpractice RVU0.57 · 18%
294
Medicare services in 2024 · #4006 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.
49435 compared with similar codes
Office rates for Kansas, from the same CMS release.
$855.87
49418 reports percutaneous insertion of a tunneled intraperitoneal catheter. 49435 is an extension add-on paired with 49421, not a substitute for the percutaneous insertion code.
$507.89
49436 addresses externalizing a previously implanted buried catheter. Use 49435 for adding and tunneling a subcutaneous extension.
Compare 49435 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
Kansas →
Office / nonfacility
Unavailable
Facility
$95.12
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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 49435 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
5,810
- Code
- 49435
- Physician work
- 2.19
- Practice expense
- 0.41
- Malpractice
- 0.57
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.19 | × 1.000 | 2.1900 |
| Practice expense | 0.41 | × 0.904 | 0.3706 |
| Malpractice | 0.57 | × 0.504 | 0.2873 |
| Total RVUs | 2.8479 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$95.12
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.19 | 1 |
| Practice expense | 0.41 | 0.904 |
| Malpractice | 0.57 | 0.504 |
(2.19 × 1 + 0.41 × 0.904 + 0.57 × 0.504) × $33.4009 = $95.12
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.
49435 billing questions
Which primary code is paired with 49435?
Report 49435 with 49421 for open insertion of a tunneled intraperitoneal dialysis catheter. It is not a stand-alone code.
When is an extension distinct from catheter insertion?
49435 describes adding and tunneling a subcutaneous segment to create a different exit site, such as a presternal site. It does not describe placing the intraperitoneal catheter itself.
What documentation supports 49435?
Document the catheter involved, the subcutaneous extension and tunneling, and the resulting exit-site location. The record should also support the qualifying 49421 primary procedure.
Is 49435 paid separately during the global period?
CMS identifies 49435 as an add-on paid within the primary procedure’s global period. Report it with 49421 rather than as a separate stand-alone service.
Can 49435 be used when a buried catheter is brought out through the skin?
That circumstance is described by 49436, which addresses externalizing a previously implanted catheter. 49435 is for adding a subcutaneous extension.
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.
5,80749427,,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
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
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958