No office rate
Choose 49418 for percutaneous tunneled placement without a port. Choose 49419 when the catheter is placed with a subcutaneous port.
On this page
CMS RVU26D · Effective 2026-10-01
49418 Peritoneal catheter Medicare reimbursement rates in Massachusetts
Report this service for initial percutaneous placement of a tunneled catheter into the peritoneal cavity when ongoing access, such as ascites drainage, is needed. Compare 49418 office and facility rates across CMS payment localities in Massachusetts.
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 49418 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$980.83–$1097.65
2 of 2 localities have a supported rate.
Facility setting
$175.41–$184.38
2 of 2 localities have a supported rate.
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.
Abdominal procedures
About 49418: Percutaneous tunneled peritoneal catheter placement
Report this service for initial percutaneous placement of a tunneled catheter into the peritoneal cavity when ongoing access, such as ascites drainage, is needed.
This code covers percutaneous placement of a tunneled catheter through the abdominal wall into the peritoneal cavity. It provides ongoing peritoneal access, commonly for drainage of recurrent ascites, including malignant ascites. Interventional radiologists often perform the procedure; surgeons may also place the catheter. The catheter is tunneled, but this service does not include placement of a subcutaneous port.
Select the code when the record supports a new catheter placed percutaneously and tunneled into the peritoneal cavity. Document the indication, access route, tunneling, and final catheter position; distinguish a catheter with a port or an exchange of an existing catheter. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires medical-necessity documentation; co-surgeons and team surgery are not permitted.
CMS billing rules for 49418
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.86 · 14%
- Practice expense (office) RVU23.83 · 85%
- Malpractice RVU0.44 · 2%
6.9K
Medicare services in 2024 · #1670 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.
49418 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
49421 is for open insertion of a tunneled intraperitoneal catheter for dialysis. This code describes percutaneous placement.
$575.44–$647.16
49423 describes exchange of an existing drainage catheter. Use 49418 for initial percutaneous placement of a tunneled intraperitoneal catheter.
No office rate
49422 is for removal of a tunneled intraperitoneal catheter; 49418 is for placing one.
Compare 49418 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
$1097.65
Facility
$184.38
Rest Of Massachusetts →
Office / nonfacility
$980.83
Facility
$175.41
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49418 billing questions
How is this code distinguished from 49419?
49418 describes percutaneous placement of a tunneled intraperitoneal catheter without a port. Use 49419 when the placement includes a subcutaneous port.
Is this the code for an open peritoneal dialysis catheter placement?
No. 49421 describes open insertion of a tunneled intraperitoneal catheter for dialysis; 49418 is for percutaneous placement.
Can catheter imaging or guidance be billed separately?
The submitted facts do not specify separate reporting for imaging or guidance. The record should clearly support the percutaneous catheter placement and its final position.
Can modifier 50 be used for bilateral placement?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What documentation supports reporting 49418 rather than an exchange code?
Document that a new tunneled catheter was placed percutaneously, including the indication, route, and final position. An exchange of an existing drainage catheter is a different service.
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.
5,79649407,,Image cath fluid trns/vgnl,A,,4.14,17.41,,0.74,,0.51,22.06,5.39,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,79749411,,Ins mark abd/pel for rt perq,A,,3.48,10.25,,0.90,,0.36,14.09,4.74,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,79849412,,Ins device for rt guide open,A,,1.46,0.36,NA,0.36,,0.39,2.21,2.21,0,ZZZ,0.00,0.00,0.00,0,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,79949418,,Insert tun ip cath perc,A,,3.86,23.83,,0.93,,0.44,28.13,5.23,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80049419,,Insert tun ip cath w/port,A,,6.90,3.23,NA,3.23,,1.59,11.72,11.72,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80149421,,Ins tun ip cath for dial opn,A,,4.10,1.06,NA,1.06,,1.03,6.19,6.19,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80249422,,Remove tunneled ip cath,A,,3.90,1.18,NA,1.18,,0.96,6.04,6.04,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00