No office rate
This is a comprehensive operation for ovarian, tubal, or primary peritoneal malignancy that includes omentectomy with other specified procedures. It is not the code for an isolated omentectomy.
On this page
CMS RVU26D · Effective 2026-10-01
49255 Omentectomy Medicare reimbursement rates in Wisconsin
Reports surgical removal of omental tissue when performed as a distinct service, rather than as part of a more comprehensive operation that includes it. Compare 49255 office and facility rates across CMS payment localities in Wisconsin.
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 49255 in Wisconsin?
Wisconsin 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
No supported rate
Facility setting
$675.37
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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.
Abdominal surgery
About 49255: Omentum removal
Reports surgical removal of omental tissue when performed as a distinct service, rather than as part of a more comprehensive operation that includes it.
The surgeon removes omental tissue, the fatty peritoneal apron that hangs from the stomach and overlies abdominal organs. General surgeons and gynecologic oncologists may perform an omentectomy during abdominal surgery for disease involving the omentum, including malignancy. The operative report should identify the tissue removed and the reason for resection, and distinguish this work from a larger procedure that already includes omentectomy.
Report 49255 when the omental resection is separately reportable, not merely an inherent part of a more comprehensive operation. Documentation should describe the operative work and specimen. Medicare assigns a 90-day global period, including 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 49255
- 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 RVU12.25 · 54%
- Practice expense (office) RVU7.40 · 33%
- Malpractice RVU2.86 · 13%
546
Medicare services in 2024 · #3478 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.
49255 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
Compare 49255 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$675.37
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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 49255 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
5,782
- Code
- 49255
- Physician work
- 12.25
- Practice expense
- 7.40
- Malpractice
- 2.86
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.25 | × 1.000 | 12.2500 |
| Practice expense | 7.40 | × 0.958 | 7.0892 |
| Malpractice | 2.86 | × 0.308 | 0.8809 |
| Total RVUs | 20.2201 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$675.37
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.25 | 1 |
| Practice expense | 7.4 | 0.958 |
| Malpractice | 2.86 | 0.308 |
(12.25 × 1 + 7.4 × 0.958 + 2.86 × 0.308) × $33.4009 = $675.37
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.
49255 billing questions
When should 49255 be reported separately?
Report it when the surgeon performs a distinct omental resection that is not already included in a more comprehensive procedure. The operative note should support the separate work.
Can modifier 50 be used for removal of both sides of the omentum?
No. The anatomy and descriptor make bilateral adjustment inappropriate; do not append modifier 50.
How does the multiple-procedure rule affect payment?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and 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.
5,77949190,,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
5,78049215,,Excise sacral spine tumor,A,,36.86,15.04,NA,15.04,,8.08,59.98,59.98,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78149250,,Excision of umbilicus,A,,8.78,6.13,NA,6.13,,2.10,17.01,17.01,0,090,0.09,0.81,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78249255,,Removal of omentum,A,,12.25,7.40,NA,7.40,,2.86,22.51,22.51,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78349320,,Diag laparo separate proc,A,,5.01,3.23,NA,3.23,,1.23,9.47,9.47,0,010,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78449321,,Laparoscopy biopsy,A,,5.30,3.30,NA,3.30,,1.26,9.86,9.86,0,010,0.10,0.80,0.10,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
5,78549322,,Laparoscopy aspiration,A,,5.86,3.36,NA,3.36,,1.42,10.64,10.64,0,010,0.10,0.80,0.10,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,