$1,008.64
Use 49440 when the tube terminates in the stomach. Use 49441 for percutaneous access with the tube placed into the duodenum or jejunum.
On this page
CMS RVU26D · Effective 2026-10-01
49440 Gastrostomy placement Medicare reimbursement rates in Rhode Island
Reports image-guided percutaneous placement of a tube into the stomach for enteral feeding or gastric decompression, rather than endoscopic or surgical placement. Compare 49440 office and facility rates across CMS payment localities in Rhode Island.
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 49440 in Rhode Island?
Rhode Island 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
$810.46
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$180.43
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Interventional radiology
About 49440: Percutaneous gastrostomy tube placement
Reports image-guided percutaneous placement of a tube into the stomach for enteral feeding or gastric decompression, rather than endoscopic or surgical placement.
A physician, commonly an interventional radiologist, creates percutaneous access to the stomach and places a gastrostomy tube under imaging guidance. The service is used when a patient needs enteral access for nutrition, hydration, or medication, or gastric decompression, and is commonly performed in a hospital or radiology setting. Fluoroscopic guidance, contrast injections, image documentation, and the report are part of the placement service.
Report this code for initial percutaneous placement into the stomach, not for a tube placed into the small bowel or for replacement of an existing tube. The procedure record should support the percutaneous route, gastric location, tube placement, and imaging used to confirm position. Related postoperative visits during the 10-day global period are included. When multiple procedures occur 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 for this service; assistant-at-surgery payment requires documented medical necessity, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 49440
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.83 · 16%
- Practice expense (office) RVU19.34 · 82%
- Malpractice RVU0.43 · 2%
18.4K
Medicare services in 2024 · #1182 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.
49440 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$762.56
49442 is for percutaneous cecostomy tube placement; 49440 is for a tube placed into the stomach.
No office rate
Choose 43246 for endoscopic gastrostomy placement. 49440 represents the percutaneous image-guided approach.
$581.43
49450 is for percutaneous replacement of a gastrostomy or cecostomy tube, not initial gastrostomy tube placement.
Compare 49440 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
Rhode Island →
Office / nonfacility
$810.46
Facility
$180.43
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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 49440 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
5,812
- Code
- 49440
- Physician work
- 3.83
- Practice expense
- 19.34
- Malpractice
- 0.43
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.83 | × 1.019 | 3.9028 |
| Practice expense | 19.34 | × 1.033 | 19.9782 |
| Malpractice | 0.43 | × 0.892 | 0.3836 |
| Total RVUs | 24.2645 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$810.46
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.83 | 1.019 |
| Practice expense | 19.34 | 1.033 |
| Malpractice | 0.43 | 0.892 |
(3.83 × 1.019 + 19.34 × 1.033 + 0.43 × 0.892) × $33.4009 = $810.46
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.83 | 1.019 |
| Practice expense | 1.08 | 1.033 |
| Malpractice | 0.43 | 0.892 |
(3.83 × 1.019 + 1.08 × 1.033 + 0.43 × 0.892) × $33.4009 = $180.43
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.
49440 billing questions
How does 49440 differ from endoscopic gastrostomy placement?
49440 describes percutaneous placement using imaging guidance. Endoscopic placement, such as a PEG, uses an endoscope to establish and guide the access.
Is fluoroscopic guidance separately reported?
No. Fluoroscopic guidance, contrast injections, image documentation, and the report are included in the placement service.
Can modifier 50 be used for two-sided placement?
No. Modifier 50 is inappropriate for this gastrostomy placement service.
Does 49440 cover follow-up visits after placement?
Related postoperative visits during the 10-day global period are included.
When is assistant-at-surgery payment allowed?
Only when medical necessity for the assistant is documented. Co-surgeon and team-surgery billing are not permitted.
How is 49440 affected when other procedures occur in the same session?
The highest-valued procedure is paid in full; 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.
5,80949429,,Removal of shunt,A,,7.25,3.82,NA,3.82,,1.94,13.01,13.01,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81049435,,Insert subq exten to ip cath,A,,2.19,0.41,NA,0.41,,0.57,3.17,3.17,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81149436,,Embedded ip cath exit-site,A,,2.65,13.51,,1.99,,0.68,16.84,5.32,0,010,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81249440,,Place gastrostomy tube perc,A,,3.83,19.34,,1.08,,0.43,23.60,5.34,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81349441,,Place duod/jej tube perc,A,,4.41,24.27,,1.39,,0.71,29.39,6.51,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81449442,,Place cecostomy tube perc,A,,3.66,18.18,,1.32,,0.36,22.20,5.34,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,81549446,,Change g-tube to g-j perc,A,,2.98,19.53,,0.45,,0.35,22.86,3.78,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537