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CMS RVU26D · Effective 2026-10-01

49187 Open lesion surgery Medicare reimbursement rates in Oklahoma

Open surgery to excise or destroy an intra-abdominal tumor, cyst, or endometrioma measuring 5.1–10 cm. Compare 49187 office and facility rates across CMS payment localities in Oklahoma.

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 49187 in Oklahoma?

Oklahoma has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$1455.93

1 of 1 localities have a supported rate.

Payment area: Oklahoma

One mapped payment locality.

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.

Find 49187 in your payment locality →

Surgical procedures

About 49187: Open intra-abdominal lesion surgery, 5.1–10 cm

Open surgery to excise or destroy an intra-abdominal tumor, cyst, or endometrioma measuring 5.1–10 cm.

This code describes open surgical excision or destruction of an intra-abdominal tumor, cyst, or endometrioma in the 5.1–10 cm size band. General surgeons, gynecologic surgeons, or surgical oncologists may perform the service when treating a lesion that requires open access. The code distinguishes this work by the lesion’s size as well as the open approach and treatment performed.

Select the size-level code supported by the documented lesion measurement. The operative report should identify the target and location, the open approach, whether the lesion was excised or destroyed, and its size. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.

CMS billing rules for 49187

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 RVU27.93 · 60%
  • Practice expense (office) RVU11.95 · 26%
  • Malpractice RVU6.42 · 14%

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.

49187 compared with similar codes

Office rates for Oklahoma, from the same CMS release.

49186

Open lesion removal

Largest tumor 5 cm or less

No office rate

This sibling is for the smaller lesion size band. Use 49187 for a lesion measuring 5.1–10 cm.

49188

Open lesion treatment

10.1–20 cm lesion

No office rate

This sibling is for the next larger lesion size band. Use 49187 when the documented measurement falls within 5.1–10 cm.

49180

Mass biopsy

Percutaneous abdominal mass

$157.46

49180 is for biopsy of an abdominal mass; 49187 describes open excision or destruction of a lesion in the specified size band.

49185

Fluid collection treatment

Percutaneous sclerotherapy

$1,084.37

49185 describes sclerotherapy of a fluid collection, rather than open excision or destruction of an intra-abdominal tumor, cyst, or endometrioma.

Compare 49187 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.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 49187 in Oklahoma.

PPRRVU2026_Oct_nonQPP.csv

5,776

Code
49187
Physician work
27.93
Practice expense
11.95
Malpractice
6.42

GPCI2026.csv

86

Locality
Oklahoma
Physician work
1.000
Practice expense
0.893
Malpractice
0.777
Facility calculation for 49187 in Oklahoma
ComponentRVULocality factorAdjusted
Physician work27.93× 1.00027.9300
Practice expense11.95× 0.89310.6714
Malpractice6.42× 0.7774.9883
Total RVUs43.5897
Conversion factor× 33.4009

Facility rate, Oklahoma$1455.93

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work27.931
Practice expense11.950.893
Malpractice6.420.777

(27.93 × 1 + 11.95 × 0.893 + 6.42 × 0.777) × $33.4009 = $1455.93

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

49187 billing questions

How does 49187 differ from 49186 or 49188?

These are size-level siblings for open treatment of intra-abdominal lesions. Use 49187 when the documented lesion measures 5.1–10 cm; 49186 is the smaller size band and 49188 the next larger band.

Is this code for biopsy of an abdominal mass?

No. 49187 describes open excision or destruction of a lesion in its specified size band. 49180 is the nearby code for biopsy of an abdominal mass.

What operative documentation supports 49187?

Document the lesion’s location and size, the open approach, and whether it was excised or destroyed. The recorded measurement should support the 5.1–10 cm band.

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.

How are multiple procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; 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 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.

RVUs for 49187PPRRVU2026_Oct_nonQPP.csv, line 5,776 (RVU26D)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet