Billing code 49436: Catheter revisionMedicare rate & RVUs in Utah

Revision of a peritoneal dialysis catheter involving surgical exposure of its exit site, including treatment of an embedded catheter or correction of malposition.

CMS RVU26DEffective Oct 1, 20261 payment locality292 Medicare services in 2024

Medicare pays $533.08 for 49436 in the office in Utah (Utah). Which amount applies depends on the service address.

$533.08Office (non-facility)
$171.39Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 49436 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Utah
  2. What 49436 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 49436 covers

This service involves surgically exposing the exit site of an existing peritoneal dialysis catheter to revise it, such as freeing an embedded catheter or correcting its position. It is typically performed by a surgeon caring for patients whose catheter needs operative revision before or during use for peritoneal dialysis. The operative report should establish the existing catheter, the reason for revision, and the exposure and corrective work performed.

Report this code for the exit-site revision rather than for placement of a new catheter or removal alone. Document the catheter’s condition and the steps taken to expose and revise it. CMS assigns a 10-day global period, so related postoperative visits during that period are included. 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 multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeons require 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.

49436 in Utah

49436 office and facility rates by payment locality
Payment localityOfficeFacility
Utah$533.08$171.39

How the 49436 rate is calculated

Each of 49436’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 · 49436

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 2.65Practice expense 13.51Malpractice 0.68

16.8400 adjusted RVUs×$33.4009 conversion factor=$562.47

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 49436

49436 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 49436

Catheter revision

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 49436

Catheter revision

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49436 without 51 · national office

$562.47

Catheter revision

49436-51 · Second procedure: 50%

$281.24

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%).

When to use modifier 51

49436 compared with similar codes

Compare codes

49436 vs 49435 vs 49421 vs 49418 vs 49422: national Medicare rates

Swap in your local Medicare rate.

  • 49436
    Catheter revision · 2.65 wRVU
    $562.47
  • 49435
    Catheter extension · 2.19 wRVU
    —
  • 49421
    Dialysis catheter placement · 4.1 wRVU
    —
  • 49418
    Peritoneal catheter · 3.86 wRVU
    $939.57+$377.10
  • 49422
    Catheter removal · 3.9 wRVU
    —

How to choose

49435Catheter extension
49435 describes insertion of a subcutaneous extension to an existing peritoneal dialysis catheter. Use 49436 when the work is surgical exposure and revision of the catheter exit site.
49421Dialysis catheter placement
49421 is for open insertion of a tunneled intraperitoneal catheter. This code is for revision involving surgical exposure of an existing catheter’s exit site.
49418Peritoneal catheter
49418 describes percutaneous insertion of a tunneled intraperitoneal catheter; it does not describe surgical exposure and revision of an existing catheter exit site.
49422Catheter removal
49422 describes removal of a tunneled intraperitoneal catheter. Use this code when the service is exit-site revision rather than removal alone.

49436 billing questions

When should I report this instead of a new-catheter insertion code?

Report this service when the surgeon exposes and revises an existing catheter exit site, such as to free an embedded catheter or correct malposition. A new catheter insertion is a different service.

Is this code appropriate for an embedded peritoneal dialysis catheter?

Yes, when the embedded catheter is surgically exposed as part of the revision. The operative note should describe the exposure and any corrective work.

Are related postoperative visits separately reportable?

Related postoperative visits during the 10-day global period are included in this procedure’s payment.

Can I append modifier 50 for bilateral work?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How are other 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. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation.

What documentation supports reporting this service?

Document the existing peritoneal dialysis catheter, why revision was needed, surgical exposure of the exit site, and the revision performed, such as freeing an embedded catheter or correcting its position.

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
RVUs for 49436PPRRVU2026_Oct_nonQPP.csv, line 5,811 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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