CPT code 49082: Paracentesis2026 Medicare rate & RVUs in Nebraska

Needle drainage of peritoneal fluid without imaging guidance for diagnostic sampling or relief of ascites is reported with CPT 49082.

CMS RVU26DEffective Oct 1, 20261 payment locality8.4K Medicare services in 2024

Medicare pays $225.76 for 49082 in the office in Nebraska (Nebraska). Which amount applies depends on the service address.

$225.76Office (non-facility)
$65.14Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 49082 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Nebraska
  2. What 49082 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 49082 covers

49082 represents needle or catheter entry through the abdominal wall into the peritoneal cavity to withdraw ascitic fluid without imaging guidance. The procedure may be diagnostic, such as sampling new or worsening ascites for evaluation, or therapeutic to relieve symptomatic fluid accumulation, including ascites associated with cirrhosis or malignancy. Physicians commonly perform it at the bedside or in hospital and clinic settings.

Choose 49082 when the tap is performed without imaging guidance; when imaging guides the procedure, report 49083 instead. Documentation should identify the indication, technique, fluid obtained, amount removed, and whether a specimen was sent for testing. Separately performed laboratory analysis is reported under the applicable lab codes. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, CMS pays the highest-valued procedure in full and the others at 50%. Modifier 50 is inappropriate. CMS does not pay an assistant at surgery; co-surgeons and team surgery are 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.

49082 in Nebraska

49082 office and facility rates by payment locality
Payment localityOfficeFacility
Nebraska$225.76$65.14

How the 49082 rate is calculated

Each of 49082’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 · 49082

RVUs × geographic indexes × conversion factor

Work1.21

1.21 RVUs× 1.000 GPCI

Practice expense5.93

5.93 RVUs× 1.000 GPCI

Malpractice0.20

0.20 RVUs× 1.000 GPCI

Adjusted RVUs

7.3400

Conversion factor

$33.4009

Medicare rate

$245.16

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 49082

The CMS indicators that decide how 49082 is paid alongside other services.

CMS payment indicators · 49082

Paracentesis

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49082 without 51 · national office

$245.16

Paracentesis

49082-51 · Second procedure: 50%

$122.58

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%).

When to use modifier 51

49082 compared with similar codes

Compare codes · National

4 codes, side by side

  • 49082

    Paracentesis1.21 wRVU

    $245.16

  • 49083

    Paracentesis1.95 wRVU

    $284.24+$39.08

  • 49084

    Peritoneal lavage1.95 wRVU

    Not priced

  • 49020

    Abscess drainage26 wRVU

    Not priced

How to choose

49083Paracentesis
Use 49083 when imaging guidance is used for the paracentesis; 49082 describes the procedure without imaging guidance.
49084Peritoneal lavage
49084 describes peritoneal lavage, a washout procedure. Paracentesis withdraws ascitic fluid for sampling or symptom relief.
49020Abscess drainage
49020 is open drainage of an abdominal abscess. It is not the needle or catheter removal of ascitic fluid described by 49082.

49082 billing questions

When should I report 49083 instead?

Report 49083 when imaging guidance is used for the paracentesis. Use 49082 when the procedure is performed without imaging guidance.

Can the ascitic-fluid tests be billed separately?

Yes. Separately performed laboratory testing, such as a fluid cell count or albumin measurement, may be reported under the applicable laboratory codes.

Is modifier 50 appropriate for bilateral paracentesis?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How many units should be reported when a large volume is removed?

Report the procedure, not a unit for each volume removed. Document the amount drained, but do not use the volume as the unit count.

Does the code include same-day care?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

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
RVUs for 49082PPRRVU2026_Oct_nonQPP.csv, line 5,770 (RVU26D)
Geographic factors for NebraskaGPCI2026.csv, line 72 (RVU26D)

Open CMS sourceHow we calculate rates

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