Billing code 49000: Abdominal explorationMedicare rate & RVUs in Texas
Reports an open operative examination of the abdominal cavity, typically when a surgeon must investigate suspected injury or disease without a more definitive procedure.
CMS doesn’t publish an office rate for 49000 in Texas.
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 49000 covers
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.
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.
Where 49000 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $730.91 |
| Beaumont | Unavailable | $701.89 |
| Brazoria | Unavailable | $707.98 |
| Dallas | Unavailable | $717.33 |
| Fort Worth | Unavailable | $716.44 |
| Galveston | Unavailable | $713.24 |
| Houston | Unavailable | $768.34 |
| Rest Of Texas | Unavailable | $707.85 |
How the 49000 rate is calculated
Each of 49000’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 · 49000
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 12.23Practice expense 6.58Malpractice 3.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49000
49000 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49000
Abdominal exploration
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 49000
Abdominal exploration
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49000 without 51 · national facility
$728.81
Abdominal exploration
49000-51 · Second procedure: 50%
$364.41
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%).
49000 compared with similar codes
Compare codes
49000 vs 49002 vs 49010 vs 49020 vs 49040: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 49002Abdominal reoperation
- 49000 describes an initial open abdominal exploration; 49002 is for reopening a prior abdominal incision to explore.
- 49010Retroperitoneal exploration
- 49000 concerns exploration of the abdominal cavity. 49010 is selected when the operative exploration is in the retroperitoneal space.
- 49020Abscess drainage
- Choose 49020 when the operation is open drainage of an abdominal abscess. 49000 describes exploration rather than abscess drainage as the operative objective.
- 49040Abscess drainage
- 49040 describes open drainage of a localized abdominal abscess; 49000 is for an open abdominal exploration without that drainage service as the defining objective.
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 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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