Billing code 49436: Catheter revisionMedicare rate & RVUs in Kansas
Revision of a peritoneal dialysis catheter involving surgical exposure of its exit site, including treatment of an embedded catheter or correction of malposition.
Medicare pays $507.89 for 49436 in the office in Kansas (Kansas). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 49436 covers
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.
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 in Kansas
| Payment locality | Office | Facility |
|---|---|---|
| Kansas | $507.89 | $160.05 |
How the 49436 rate is calculated
Each of 49436’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 49436
RVUs × geographic indexes × conversion factor
Work2.65
2.65 RVUs× 1.000 GPCI
Practice expense13.51
13.51 RVUs× 1.000 GPCI
Malpractice0.68
0.68 RVUs× 1.000 GPCI
Adjusted RVUs
16.8400
Conversion factor
$33.4009
Medicare rate
$562.47
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49436
49436 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49436
Catheter revision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 49436
Catheter revision
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49436 without 51 · national office
$562.47
Catheter revision
49436-51 · Second procedure: 50%
$281.24
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
49436 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 49435Catheter extension
- 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.
- 49421Dialysis catheter placement
- 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.
- 49418Peritoneal catheter
- 49418 describes percutaneous insertion of a tunneled intraperitoneal catheter; it does not describe surgical exposure and revision of an existing catheter exit site.
- 49422Catheter removal
- 49422 describes removal of a tunneled intraperitoneal catheter. Use this code when the service is exit-site revision rather than removal alone.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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