$612.46
Use 49451 for a percutaneous duodenostomy or jejunostomy tube exchange; 49450 is for a gastrostomy or cecostomy tube.
On this page
CMS RVU26D · Effective 2026-10-01
49450 Feeding tube replacement Medicare reimbursement rates in Minnesota
Report this service when a clinician replaces an existing gastrostomy or cecostomy tube percutaneously using fluoroscopic guidance and contrast assessment. Compare 49450 office and facility rates across CMS payment localities in Minnesota.
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 49450 in Minnesota?
Minnesota 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
$575.54
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
Facility setting
$53.12
1 of 1 localities have a supported rate.
Payment area: Minnesota
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.
Image-guided procedure
About 49450: Percutaneous gastrostomy or cecostomy tube replacement
Report this service when a clinician replaces an existing gastrostomy or cecostomy tube percutaneously using fluoroscopic guidance and contrast assessment.
This service covers percutaneous replacement of an existing gastrostomy or cecostomy tube, with fluoroscopic guidance and contrast assessment to confirm tube position and function. It is commonly performed by an interventional radiologist in an imaging suite when a tube is dislodged, malfunctioning, or due for exchange. It is a replacement through an established tract, not creation of a new gastrostomy or cecostomy tract.
Report the code when documentation supports replacement of the existing tube and the imaging work associated with the exchange. The 0-day global includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 49450
- 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 RVU1.33 · 8%
- Practice expense (office) RVU15.41 · 91%
- Malpractice RVU0.15 · 1%
20.2K
Medicare services in 2024 · #1145 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.
49450 compared with similar codes
Office rates for Minnesota, from the same CMS release.
$738.52
Use 49452 for a gastrojejunostomy tube exchange. 49450 applies to gastrostomy or cecostomy tube replacement.
$275.73
43762 is gastrostomy tube replacement without imaging or endoscopic guidance. 49450 includes fluoroscopic guidance and contrast assessment and also covers cecostomy tube replacement.
$131.65
49465 is a fluoroscopic tube assessment without replacement. When the tube is replaced and the associated imaging is performed, report 49450 instead of separately reporting that same assessment.
Compare 49450 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
Minnesota →
Office / nonfacility
$575.54
Facility
$53.12
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 49450 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
5,816
- Code
- 49450
- Physician work
- 1.33
- Practice expense
- 15.41
- Malpractice
- 0.15
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.33 | × 1.000 | 1.3300 |
| Practice expense | 15.41 | × 1.029 | 15.8569 |
| Malpractice | 0.15 | × 0.296 | 0.0444 |
| Total RVUs | 17.2313 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Minnesota$575.54
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.33 | 1 |
| Practice expense | 15.41 | 1.029 |
| Malpractice | 0.15 | 0.296 |
(1.33 × 1 + 15.41 × 1.029 + 0.15 × 0.296) × $33.4009 = $575.54
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.33 | 1 |
| Practice expense | 0.21 | 1.029 |
| Malpractice | 0.15 | 0.296 |
(1.33 × 1 + 0.21 × 1.029 + 0.15 × 0.296) × $33.4009 = $53.12
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.
49450 billing questions
How does this differ from 49451 or 49452?
49450 is for replacing a gastrostomy or cecostomy tube. Use 49451 for a duodenostomy or jejunostomy tube and 49452 for a gastrojejunostomy tube.
Can the fluoroscopic tube check be reported separately?
Fluoroscopic guidance, contrast assessment, and related image documentation for the replacement are included in 49450. Do not separately report a tube check for that same work.
When is 49450 preferable to 43762?
49450 describes replacement with fluoroscopic guidance. 43762 is for percutaneous gastrostomy tube replacement without imaging or endoscopic guidance.
Does 49450 have a global period?
It has a 0-day global period, so same-day preoperative and postoperative care is included.
Can modifier 50 be used for two tubes?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service based on the documented procedure and applicable claim rules.
What documentation supports reporting 49450?
Document the existing gastrostomy or cecostomy tube, the replacement performed, and the imaging and contrast assessment supporting the exchange.
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.
5,81349441,,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
5,81449442,,Place cecostomy tube perc,A,,3.66,18.18,,1.32,,0.36,22.20,5.34,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81549446,,Change g-tube to g-j perc,A,,2.98,19.53,,0.45,,0.35,22.86,3.78,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81649450,,Replace g/c tube perc,A,,1.33,15.41,,0.21,,0.15,16.89,1.69,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81749451,,Replace duod/jej tube perc,A,,1.79,16.02,,0.28,,0.21,18.02,2.28,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81849452,,Replace g-j tube perc,A,,2.79,18.69,,0.41,,0.30,21.78,3.50,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81949460,,Fix g/colon tube w/device,A,,0.94,20.31,,0.22,,0.12,21.37,1.28,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002