No office rate
49000 describes an initial open abdominal exploration; 49002 is for reopening a prior abdominal incision to explore.
On this page
CMS RVU26D · Effective 2026-10-01
49000 Abdominal exploration Medicare reimbursement rates in New Jersey
Reports an open operative examination of the abdominal cavity, typically when a surgeon must investigate suspected injury or disease without a more definitive procedure. Compare 49000 office and facility rates across CMS payment localities in New Jersey.
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 49000 in New Jersey?
New Jersey 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
No supported rate
Facility setting
$775.12–$796.54
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.
General surgery
About 49000: Open abdominal exploration
Reports an open operative examination of the abdominal cavity, typically when a surgeon must investigate suspected injury or disease without a more definitive procedure.
A surgeon opens the abdomen to inspect the abdominal cavity and its organs when the cause or extent of a problem is uncertain. General and trauma surgeons may perform this exploration in a hospital operating room for situations such as suspected internal injury or an acute abdominal condition. Tissue sampling may be part of the examination. The service represents an operative exploration, not simply visual inspection during another abdominal operation.
Report the exploration when it is the operative service performed; if a more definitive intra-abdominal operation is completed during the same session, the preliminary survey is included in that operation. The operative report should establish why exploration was needed, what areas were examined, and whether additional treatment or biopsy occurred. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed 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 may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 49000
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.23 · 56%
- Practice expense (office) RVU6.58 · 30%
- Malpractice RVU3.01 · 14%
4.9K
Medicare services in 2024 · #1879 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.
49000 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
49000 concerns exploration of the abdominal cavity. 49010 is selected when the operative exploration is in the retroperitoneal space.
No office rate
Choose 49020 when the operation is open drainage of an abdominal abscess. 49000 describes exploration rather than abscess drainage as the operative objective.
No office rate
49040 describes open drainage of a localized abdominal abscess; 49000 is for an open abdominal exploration without that drainage service as the defining objective.
Compare 49000 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
Northern Nj →
Office / nonfacility
Unavailable
Facility
$796.54
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$775.12
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49000 billing questions
When should 49000 be reported instead of 49002?
Use 49000 for an initial open abdominal exploration. Use 49002 when a prior abdominal incision is reopened for exploration.
Can 49000 be reported with a definitive abdominal operation?
The exploratory survey is included when a more definitive intra-abdominal operation is completed in the same session. Report the procedure that treats the condition rather than separately billing the preliminary exploration.
Does modifier 50 apply to 49000?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the 90-day global period affect billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure 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.
5,75848554,,Transpl allograft pancreas,R,,36.86,30.08,NA,30.08,,9.73,76.67,76.67,0,090,0.09,0.81,0.10,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
5,75948556,,Removal allograft pancreas,A,,18.98,13.27,NA,13.27,,5.06,37.31,37.31,0,090,0.09,0.81,0.10,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
5,76048999,,Unlisted procedure pancreas,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,76149000,,Exploration of abdomen,A,,12.23,6.58,NA,6.58,,3.01,21.82,21.82,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,76249002,,Reopening of abdomen,A,,17.19,7.71,NA,7.71,,4.27,29.17,29.17,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,76349010,,Exploration behind abdomen,A,,15.66,6.34,NA,6.34,,3.88,25.88,25.88,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,76449013,,Prpertl pel pack hemrrg trma,A,,8.14,1.97,NA,1.97,,2.17,12.28,12.28,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00