CPT 49013
Global 000 ActivePrpertl pel pack hemrrg trma
CPT 49013 Billing & Documentation Guide
CPT code 49013 (Prpertl pel pack hemrrg trma) is classified under Surgery (Digestive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 8.14, a non-facility practice expense RVU of 1.97, and a malpractice RVU of 2.17, a total non-facility RVU of 12.28 and facility RVU of 12.28. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $408.15, though rates vary from $357.24 to $523.68 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 49013, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 49013 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 49013 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 49013
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 8.14 | 8.14 |
| Practice Expense RVU | 1.97 | 1.97 |
| Malpractice RVU | 2.17 | 2.17 |
| Total RVU | 12.28 | 12.28 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 49013
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $398.79 | $398.79 | $387.47 - $435.52 | 29 |
| Florida | $479 | $479 | $443.73 - $523.68 | 3 |
| Georgia | $421.79 | $421.79 | $416.97 - $426.6 | 2 |
| Illinois | $474.92 | $474.92 | $445.24 - $506.26 | 4 |
| Michigan | $435.69 | $435.69 | $413.79 - $457.58 | 2 |
| North Carolina | $379.59 | $379.59 | $379.59 - $379.59 | 1 |
| New York | $456.72 | $456.72 | $385.35 - $502.12 | 5 |
| Ohio | $405.02 | $405.02 | $405.02 - $405.02 | 1 |
| Pennsylvania | $416.26 | $416.26 | $400.78 - $431.74 | 2 |
| Texas | $405.48 | $405.48 | $395.8 - $439.13 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 49013
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 49013 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0230T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 49013
What does CPT code 49013 mean? +
CPT code 49013 represents: Prpertl pel pack hemrrg trma. It's in the Surgery (Digestive) category with a global period of 000.
What is the Medicare reimbursement for CPT 49013? +
The 2026 Medicare national average non-facility payment for CPT 49013 is $408.15. Rates range from $357.24 to $523.68 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 49013? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 49013? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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