CPT 49614
Global 000 ActiveRpr aa hrn rcr < 3 ncr/strn
CPT 49614 Billing & Documentation Guide
CPT code 49614 (Rpr aa hrn rcr < 3 ncr/strn) is classified under Surgery (Digestive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 9.99, a non-facility practice expense RVU of 3.09, and a malpractice RVU of 2.61, a total non-facility RVU of 15.69 and facility RVU of 15.69. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $522.82, though rates vary from $459.4 to $661.58 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 49614, 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 49614 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 49614 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 49614
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 9.99 | 9.99 |
| Practice Expense RVU | 3.09 | 3.09 |
| Malpractice RVU | 2.61 | 2.61 |
| Total RVU | 15.69 | 15.69 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 49614
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 | $515.03 | $515.03 | $499.19 - $565.93 | 29 |
| Florida | $606.93 | $606.93 | $563.37 - $661.58 | 3 |
| Georgia | $536.94 | $536.94 | $529.65 - $544.23 | 2 |
| Illinois | $601.16 | $601.16 | $564.16 - $639.81 | 4 |
| Michigan | $553.29 | $553.29 | $526.33 - $580.25 | 2 |
| North Carolina | $485.67 | $485.67 | $485.67 - $485.67 | 1 |
| New York | $583.16 | $583.16 | $493.01 - $639.63 | 5 |
| Ohio | $515.78 | $515.78 | $515.78 - $515.78 | 1 |
| Pennsylvania | $530.96 | $530.96 | $510.8 - $551.12 | 2 |
| Texas | $518.09 | $518.09 | $506.62 - $558.79 | 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 49614
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 49614 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 |
| 0437T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 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 |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 49614
What does CPT code 49614 mean? +
CPT code 49614 represents: Rpr aa hrn rcr < 3 ncr/strn. It's in the Surgery (Digestive) category with a global period of 000.
What is the Medicare reimbursement for CPT 49614? +
The 2026 Medicare national average non-facility payment for CPT 49614 is $522.82. Rates range from $459.4 to $661.58 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 49614? +
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 49614? +
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 20, 2026.
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