CPT 49186 Surgery - Digestive
Opn exc/dstr ntra-abd 5 cm/< Cost
Body System: Digestive
Medicare Facility Rate
$1,221
CMS PFS CY2026
Medicare Non-Facility Rate
$1,221
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
21.45
Work RVU
10.28
Facility PE RVU
4.84
Malpractice RVU
36.57
Total RVU
Frequently Asked Questions
How much does Opn exc/dstr ntra-abd 5 cm/< cost?
The Medicare facility rate is $1,221. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Opn exc/dstr ntra-abd 5 cm/< cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $1,221.