$262.07
This code is for percutaneous biopsy of an abdominal mass; 47000 is specific to biopsy of the liver.
On this page
CMS RVU26D · Effective 2026-10-01
49180 Mass biopsy Medicare reimbursement rates in Kentucky
Reports percutaneous tissue sampling of an abdominal mass for pathologic evaluation, rather than open removal or treatment of the mass. Compare 49180 office and facility rates across CMS payment localities in Kentucky.
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 49180 in Kentucky?
Kentucky 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
$157.86
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$69.67
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Diagnostic procedure
About 49180: Percutaneous abdominal mass biopsy
Reports percutaneous tissue sampling of an abdominal mass for pathologic evaluation, rather than open removal or treatment of the mass.
A clinician obtains tissue from an abdominal mass through the skin, commonly using a needle and imaging to target a lesion that cannot be sampled safely by direct examination. Interventional radiologists and other qualified physicians perform this procedure in hospital and outpatient settings. The specimen is sent for pathologic examination; this code describes sampling, not removal of the mass.
Select the code when the target is an abdominal mass and the approach is percutaneous. The procedure note should identify the target, approach, tissue obtained, and any imaging guidance performed. Report imaging guidance separately when appropriate. The 0-day global period includes same-day preoperative and postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 49180
- 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 RVU1.69 · 33%
- Practice expense (office) RVU3.23 · 63%
- Malpractice RVU0.18 · 4%
20.8K
Medicare services in 2024 · #1130 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.
49180 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$1,081.28
49180 samples tissue from a mass. 49185 treats a fluid collection with sclerotherapy.
No office rate
49180 describes percutaneous diagnostic sampling; 49186 describes open excision or destruction of a small intra-abdominal tumor.
Compare 49180 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
Kentucky →
Office / nonfacility
$157.86
Facility
$69.67
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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 49180 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
5,773
- Code
- 49180
- Physician work
- 1.69
- Practice expense
- 3.23
- Malpractice
- 0.18
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.69 | × 1.000 | 1.6900 |
| Practice expense | 3.23 | × 0.889 | 2.8715 |
| Malpractice | 0.18 | × 0.915 | 0.1647 |
| Total RVUs | 4.7262 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$157.86
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.69 | 1 |
| Practice expense | 3.23 | 0.889 |
| Malpractice | 0.18 | 0.915 |
(1.69 × 1 + 3.23 × 0.889 + 0.18 × 0.915) × $33.4009 = $157.86
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.69 | 1 |
| Practice expense | 0.26 | 0.889 |
| Malpractice | 0.18 | 0.915 |
(1.69 × 1 + 0.26 × 0.889 + 0.18 × 0.915) × $33.4009 = $69.67
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.
49180 billing questions
When is 49180 appropriate instead of an organ-specific biopsy code?
Use 49180 for percutaneous sampling of an abdominal mass when the target is not better represented by a site-specific biopsy code. For a liver target, consider the liver biopsy code 47000.
Is imaging guidance included?
When CT or ultrasound guidance is performed, report the applicable guidance service separately when appropriate. The record should support the guidance method and its use to direct needle placement.
Does the code include removal of the entire mass?
No. It represents percutaneous tissue sampling for diagnosis, not open excision or destruction of an intra-abdominal tumor.
What is included in the 0-day global period?
Same-day preoperative and postoperative care is included. The global period does not extend beyond the day of the procedure.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 49180. Co-surgeon and team-surgery billing are not permitted.
How does the multiple-procedure reduction affect the claim?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% reduction.
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.
5,77049082,,Abd paracentesis,A,,1.21,5.93,,0.72,,0.20,7.34,2.13,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77149083,,Abd paracentesis w/imaging,A,,1.95,6.35,,0.62,,0.21,8.51,2.78,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77249084,,Peritoneal lavage,A,,1.95,0.46,NA,0.46,,0.46,2.87,2.87,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77349180,,Biopsy abdominal mass,A,,1.69,3.23,,0.26,,0.18,5.10,2.13,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77449185,,Sclerotx fluid collection,A,,2.29,33.53,,0.56,,0.30,36.12,3.15,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77549186,,Opn exc/dstr ntra-abd 5 cm/<,A,,21.45,10.28,NA,10.28,,4.84,36.57,36.57,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77649187,,Opn exc/dstr ntra-abd 5.1-10,A,,27.93,11.95,NA,11.95,,6.42,46.30,46.30,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631