Billing code 49082: ParacentesisMedicare rate & RVUs in Ohio
Needle drainage of peritoneal fluid without imaging guidance for diagnostic sampling or relief of ascites is reported with billing code 49082.
Medicare pays $227.98 for 49082 in the office in Ohio (Ohio). Which amount applies depends on the service address.
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 9 sections
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 Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $227.98 | $69.11 |
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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%).
49082 compared with similar codes
Compare codes · National
4 codes, side by side
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
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