Billing code 49215: Tumor excisionMedicare rate & RVUs in Nevada
Reports operative removal of a tumor in the presacral space or sacrum, such as a sacral chordoma, rather than an intra-abdominal mass.
CMS doesn’t publish an office rate for 49215 in Nevada.
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 7 sections
What 49215 covers
This service covers operative removal of a tumor arising in the presacral space or sacrum. Examples include a sacral chordoma or a presacral mass requiring excision. Depending on the tumor’s location and extent, the operation may use an abdominal, posterior, or combined approach. Colorectal or general surgeons, surgical oncologists, orthopedic spine surgeons, and neurosurgeons may perform the procedure in a hospital operating room.
Select the code based on the presacral or sacral location, not a size tier used for other intra-abdominal tumor excisions. The operative report should identify the tumor’s site and describe its removal and surgical approach. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued is paid in full and the others at 50%. Modifier 50 is inappropriate for this service. An assistant at surgery may be paid; co-surgeon payment requires 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.
49215 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $1,958.82 |
How the 49215 rate is calculated
Each of 49215’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 · 49215
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 36.86Practice expense 15.04Malpractice 8.08
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49215
49215 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49215
Tumor excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 49215
Tumor excision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49215 without 51 · national facility
$2,003.39
Tumor excision
49215-51 · Second procedure: 50%
$1,001.70
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%).
49215 billing questions
How is this code distinguished from size-based intra-abdominal tumor excisions?
Use this code for a tumor in the presacral space or sacrum. The intra-abdominal tumor codes are selected for tumors at other covered sites, with size determining the level.
Does tumor size determine code selection?
No. The key distinction is the presacral or sacral location, not a size threshold.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this service and anatomy.
What documentation supports reporting this code?
The operative report should identify the presacral or sacral tumor, its location, the surgical approach, and the excision performed.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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