How much does Medicare pay for CPT 49450?

Medicare allowed an average of $270.04 per service and paid $211.23 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1071.02, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 49450?

Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast. It was billed 5,881 times to 4,664 Medicare beneficiaries by 231 providers in 2024.

Does 49450 pay differently in an office than a hospital?

Yes. The allowed amount averaged $587.77 in an office setting and $60.82 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 49450 most?

Physician Assistant, with 1,976 services from 52 clinicians. Next are Diagnostic Radiology, Interventional Radiology, Nurse Practitioner.

CPT 49450

Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast

$270.04Medicare-allowed amount per service, averaged across 5,881 services

Providers submitted

$1071.02

Asking price, not received

Medicare allowed

$270.04

The fee schedule figure

Medicare paid

$211.23

Balance is patient coinsurance

Providers submitted an average of $1071.02 for this code and Medicare allowed $270.04 — 4.0× 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 $211.23 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $587.77
Hospital / facility: $60.82

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 2,335 services were billed in an office setting and 3,546 in a facility.

Services: 5,881
Beneficiaries: 4,664
Providers billing it: 231
Total allowed: $1,588,105

What Medicare pays for CPT 49450

Across 5,881 services billed by 231 providers to 4,664 beneficiaries, Medicare allowed an average of $270.04 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. 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 49450

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physician Assistant	1,976	1,503	$345.30	52
Diagnostic Radiology	1,427	1,196	$98.62	78
Interventional Radiology	964	832	$76.91	54
Nurse Practitioner	676	527	$434.90	25
General Surgery	327	274	$575.51	9
General Practice	219	117	$528.69	4
Internal Medicine	183	129	$252.43	5
Emergency Medicine	38	28	$605.98	1
Plastic and Reconstructive Surgery	32	25	$666.16	1
Thoracic Surgery	24	20	$62.62	1
Vascular Surgery	15	13	$60.31	1

49450 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
California	3,024	$418.86	$282.04	83
Texas	417	$161.66	$130.76	12
Pennsylvania	276	$138.41	$103.64	16
Florida	272	$147.88	$102.36	17
Massachusetts	234	$130.33	$85.68	10
New York	181	$161.66	$111.88	11
New Jersey	134	$60.57	$43.73	6
Delaware	109	$61.55	$48.54	6
Minnesota	106	$58.27	$48.81	6
North Carolina	78	$58.70	$44.53	5
Hawaii	76	$52.32	$39.63	2
Washington	73	$252.45	$193.25	4
Virginia	73	$64.97	$48.13	2
Illinois	72	$64.31	$44.39	4
Michigan	70	$62.06	$45.10	5
Arkansas	65	$276.66	$264.70	4
Mississippi	63	$54.31	$43.43	4
Georgia	54	$64.41	$46.52	4
Ohio	51	$61.73	$45.32	2
Maryland	50	$65.27	$47.15	3
Arizona	49	$55.89	$44.99	3
North Dakota	48	$60.40	$45.44	3
Nebraska	37	$54.24	$48.95	2
Colorado	35	$62.94	$45.76	2
Connecticut	32	$59.69	$43.03	2
South Carolina	29	$54.05	$46.06	2
South Dakota	28	$48.70	$40.03	1
New Mexico	27	$59.85	$46.67	2
Iowa	25	$50.07	$39.83	2
Idaho	22	$48.09	$39.16	1
Indiana	17	$55.48	$44.14	1
District of Columbia	16	$61.49	$48.13	1
Wisconsin	14	$66.24	$48.00	1
Kentucky	12	$60.21	$49.71	1
Tennessee	12	$57.47	$49.71	1

Related codes

49406Drainage of fluid collection of abdominal cavity by tube$178.72
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
49422Removal of abdominal cavity tube$332.37

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.