No office rate
This sibling is for the smaller lesion size band. Use 49187 for a lesion measuring 5.1–10 cm.
On this page
CMS RVU26D · Effective 2026-10-01
49187 Open lesion surgery Medicare reimbursement rates in Virginia
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 Virginia.
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 Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1476.63–$1692.12
2 of 2 localities have a supported rate.
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.
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 Virginia, from the same CMS release.
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.
$166.74–$193.28
49180 is for biopsy of an abdominal mass; 49187 describes open excision or destruction of a lesion in the specified size band.
$1,184.46–$1,411.05
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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$1692.12
Virginia →
Office / nonfacility
Unavailable
Facility
$1476.63
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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.
5,77349180,,Biopsy abdominal mass,A,,1.69,3.23,,0.26,,0.18,5.10,2.13,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77449185,,Sclerotx fluid collection,A,,2.29,33.53,,0.56,,0.30,36.12,3.15,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77549186,,Opn exc/dstr ntra-abd 5 cm/<,A,,21.45,10.28,NA,10.28,,4.84,36.57,36.57,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77649187,,Opn exc/dstr ntra-abd 5.1-10,A,,27.93,11.95,NA,11.95,,6.42,46.30,46.30,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77749188,,Opn exc/dst ntra-abd 10.1-20,A,,33.15,14.67,NA,14.67,,7.64,55.46,55.46,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77849189,,Opn exc/dst ntra-abd 20.1-30,A,,39.00,16.29,NA,16.29,,9.00,64.29,64.29,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77949190,,Opn exc/dstr ntra-abd >30 cm,A,,48.75,19.26,NA,19.26,,11.04,79.05,79.05,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00