Billing code 49014: Pelvic re-explorationMedicare rate & RVUs in Texas
Reports urgent re-exploration of a recent laparotomy for traumatic pelvic bleeding when pelvic packing is performed to control hemorrhage.
CMS doesn’t publish an office rate for 49014 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 49014 covers
A surgeon reopens a recent laparotomy and re-explores the pelvis to control hemorrhage from trauma, using pelvic packing as part of the procedure. This is generally an urgent hospital operating-room service, often performed during damage-control surgery when bleeding must be controlled before definitive treatment can be completed. The operative report should establish the traumatic indication, the recent laparotomy, the pelvic focus, and the packing performed.
Report this code for the trauma-related pelvic re-exploration and packing, not for an initial abdominal exploration or a general reopening without this specific service. 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; 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.
Where 49014 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 | $343.78 |
| Beaumont | Unavailable | $335.72 |
| Brazoria | Unavailable | $334.31 |
| Dallas | Unavailable | $339.43 |
| Fort Worth | Unavailable | $339.51 |
| Galveston | Unavailable | $337.25 |
| Houston | Unavailable | $369.28 |
| Rest Of Texas | Unavailable | $336.87 |
How the 49014 rate is calculated
Each of 49014’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 · 49014
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.56Practice expense 2.05Malpractice 1.75
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49014
The CMS indicators that decide how 49014 is paid alongside other services.
CMS payment indicators · 49014
Pelvic re-exploration
| 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
49014 without 51 · national facility
$346.03
Pelvic re-exploration
49014-51 · Second procedure: 50%
$173.02
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%).
49014 compared with similar codes
Compare codes
49014 vs 49013 vs 49002 vs 49000: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 49013Pelvic packing
- 49013 applies when packing is performed in the abdomen for traumatic hemorrhage; 49014 is specific to pelvic packing.
- 49002Abdominal reoperation
- 49002 describes reopening a recent laparotomy more generally. Choose 49014 when the case is trauma-related pelvic hemorrhage treated with pelvic packing.
- 49000Abdominal exploration
- 49000 is an initial abdominal exploration. 49014 is a return to a recent laparotomy for traumatic pelvic bleeding with packing.
49014 billing questions
How does this differ from 49013?
Both involve re-exploration for traumatic hemorrhage with packing, but 49014 is for pelvic packing; 49013 is for abdominal packing. The operative note should make the packed site clear.
When would 49002 be more appropriate?
Use 49002 for reopening a recent laparotomy when the service is not the trauma-related pelvic hemorrhage procedure with packing represented by 49014.
Does the code include same-day preoperative and postoperative care?
Yes. The CMS global period is 0 days, and same-day preoperative and postoperative care is included.
Can modifier 50 be reported?
No. The bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
Can an assistant surgeon or co-surgeon be paid?
Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted under the CMS rules for this code.
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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