Billing code 49083: ParacentesisMedicare rate & RVUs in Ohio
Report image-guided abdominal paracentesis when a clinician removes peritoneal fluid for diagnosis or symptom relief using imaging to guide needle placement.
Medicare pays $265.85 for 49083 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 49083 covers
A clinician uses imaging, commonly ultrasound, to guide a needle or catheter into the peritoneal cavity and remove ascitic fluid. The procedure may obtain fluid for diagnostic testing or relieve symptoms from fluid accumulation, such as abdominal distention or discomfort. It is performed in settings including hospitals, outpatient departments, and offices by physicians or other qualified practitioners who perform paracentesis.
Select 49083 when imaging guidance is used; 49082 is the corresponding code for paracentesis without imaging guidance. Documentation should support the indication, fluid removal, and use of imaging to guide the procedure. The 0-day global period 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 others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and 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.
49083 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $265.85 | $91.11 |
How the 49083 rate is calculated
Each of 49083’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 · 49083
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.95Practice expense 6.35Malpractice 0.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49083
The CMS indicators that decide how 49083 is paid alongside other services.
CMS payment indicators · 49083
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
49083 without 51 · national office
$284.24
Paracentesis
49083-51 · Second procedure: 50%
$142.12
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%).
49083 compared with similar codes
Compare codes
49083 vs 49082 vs 49084 vs 49020: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 49082Paracentesis
- Both codes describe abdominal paracentesis; choose 49083 when imaging guides the procedure and 49082 when it does not.
- 49084Peritoneal lavage
- 49083 removes peritoneal fluid through a needle or catheter. 49084 describes peritoneal lavage rather than routine fluid drainage.
- 49020Abscess drainage
- 49083 is percutaneous fluid removal from the peritoneal cavity. 49020 describes open drainage of an abdominal abscess.
49083 billing questions
When should 49083 be selected instead of 49082?
Use 49083 when imaging is used to guide the paracentesis. Use 49082 when the paracentesis is performed without imaging guidance.
Can the imaging guidance be reported separately?
Imaging guidance is part of 49083. Do not separately report a guidance service for the same needle placement.
Can modifier 50 be appended for fluid removed from both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
What documentation supports 49083?
Document the clinical reason for drainage, that peritoneal fluid was removed, and that imaging was used to guide the procedure.
How is 49083 affected when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be billed for this procedure?
Medicare does not pay an assistant at surgery for 49083. Co-surgeons and team surgery are 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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