How much does Medicare pay for CPT 49452?

Medicare allowed an average of $126.41 per service and paid $97.81 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1044.91, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 49452?

Replacement of stomach-to-small bowel tube using fluoroscopic guidance with contrast. It was billed 1,502 times to 1,052 Medicare beneficiaries by 65 providers in 2024.

Which specialty bills 49452 most?

Diagnostic Radiology, with 749 services from 35 clinicians. Next are Interventional Radiology, Physician Assistant, Internal Medicine.

CPT 49452

Replacement of stomach-to-small bowel tube using fluoroscopic guidance with contrast

$126.41Medicare-allowed amount per service, averaged across 1,502 services

Providers submitted

$1044.91

Asking price, not received

Medicare allowed

$126.41

The fee schedule figure

Medicare paid

$97.81

Balance is patient coinsurance

Providers submitted an average of $1044.91 for this code and Medicare allowed $126.41 — 8.3× 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 $97.81 (77%); the rest is the patient’s coinsurance and deductible.

Services: 1,502
Beneficiaries: 1,052
Providers billing it: 65
Total allowed: $189,868

What Medicare pays for CPT 49452

Across 1,502 services billed by 65 providers to 1,052 beneficiaries, Medicare allowed an average of $126.41 per service. That is 1.4 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 49452

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	749	569	$125.05	35
Interventional Radiology	658	442	$130.19	28
Physician Assistant	79	26	$107.52	1
Internal Medicine	16	15	$127.68	1

49452 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
Minnesota	458	$123.76	$101.13	21
Florida	283	$132.14	$98.24	6
Pennsylvania	203	$119.68	$96.28	8
Michigan	110	$127.81	$101.46	7
Arkansas	99	$121.28	$98.52	5
New York	67	$128.29	$102.62	4
Tennessee	52	$132.65	$97.27	1
North Carolina	52	$128.33	$90.16	1
Arizona	46	$124.93	$98.93	3
Delaware	34	$129.91	$103.41	2
Illinois	30	$145.36	$103.50	2
Wisconsin	27	$121.95	$103.30	2
Texas	15	$128.13	$103.50	1
Washington	13	$143.51	$87.67	1
South Carolina	13	$127.39	$103.35	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
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.