How much does Medicare pay for CPT 49422?

Medicare allowed an average of $332.37 per service and paid $262.27 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1436.53, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 49422?

Removal of abdominal cavity tube. It was billed 1,068 times to 1,051 Medicare beneficiaries by 72 providers in 2024.

Does 49422 pay differently in an office than a hospital?

Yes. The allowed amount averaged $185.89 in an office setting and $333.89 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 49422 most?

General Surgery, with 631 services from 45 clinicians. Next are Vascular Surgery, Ambulatory Surgical Center, Nephrology.

CPT 49422

Removal of abdominal cavity tube

$332.37Medicare-allowed amount per service, averaged across 1,068 services

Providers submitted

$1436.53

Asking price, not received

Medicare allowed

$332.37

The fee schedule figure

Medicare paid

$262.27

Balance is patient coinsurance

Providers submitted an average of $1436.53 for this code and Medicare allowed $332.37 — 4.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $262.27 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $185.89
Hospital / facility: $333.89

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 11 services were billed in an office setting and 1,057 in a facility.

Services: 1,068
Beneficiaries: 1,051
Providers billing it: 72
Total allowed: $354,971

What Medicare pays for CPT 49422

Across 1,068 services billed by 72 providers to 1,051 beneficiaries, Medicare allowed an average of $332.37 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 49422

Specialty	Services	Beneficiaries	Avg allowed	Providers
General Surgery	631	623	$174.46	45
Vascular Surgery	170	166	$171.65	12
Ambulatory Surgical Center	131	129	$1462.71	6
Nephrology	64	63	$197.82	4
Undefined Physician type	20	20	$192.98	1
General Practice	15	14	$125.85	1
Urology	14	14	$153.02	1
Orthopedic Surgery	12	11	$124.48	1
Colorectal Surgery (Proctology)	11	11	$185.89	1

49422 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Texas	98	$377.66	$328.58	7
Virginia	88	$450.58	$376.27	6
California	77	$171.90	$135.64	5
Nevada	76	$952.37	$768.48	3
Florida	68	$173.92	$122.94	5
Illinois	63	$458.22	$384.78	4
New Jersey	58	$193.43	$139.48	4
Oklahoma	55	$171.13	$138.66	4
Ohio	45	$173.59	$144.09	3
Arizona	43	$137.57	$111.36	3
South Carolina	40	$163.07	$125.46	3
Pennsylvania	33	$207.96	$155.47	2
Alabama	27	$131.21	$118.35	2
Georgia	26	$1528.00	$1213.54	1
Indiana	25	$179.75	$150.74	2
New York	23	$160.29	$143.23	2
Michigan	19	$218.05	$148.61	1
Nebraska	18	$137.31	$144.98	1
Kansas	17	$172.17	$145.72	1
Tennessee	17	$114.79	$82.60	1
Hawaii	15	$133.71	$108.38	1
Iowa	15	$193.61	$169.30	1
Missouri	14	$178.79	$140.36	1
Maryland	13	$203.77	$157.86	1
Mississippi	13	$175.02	$125.98	1
District of Columbia	12	$227.41	$142.63	1
Kentucky	12	$203.52	$174.60	1
Arkansas	12	$152.22	$127.02	1
Massachusetts	12	$151.54	$114.01	1
Louisiana	12	$199.64	$164.34	1
Wisconsin	11	$1428.48	$1241.11	1
North Carolina	11	$185.89	$170.96	1

Related codes

49406Drainage of fluid collection of abdominal cavity by tube$178.72
49450Replacement of stomach or large bowel tube$270.04
49440Insertion of stomach tube$197.64
49424Injection of contrast through abdominal cavity tube for x-ray study$32.06
49452Replacement of stomach-to-small bowel tube$126.41
49465Contrast injection for x-ray imaging through existing tube in stomach$30.29

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.