CPT code 49190 covers an open abdominal surgical procedure to excise or destroy one or more tumors or cysts when the total maximum length of the lesions is greater than 30 cm. This code captures a high-complexity operative intervention that has implications for surgical case complexity, inpatient resource use, and facility reimbursement. Nationally, accurate coding of large or multiple intra-abdominal masses supports appropriate payment and clinical documentation for major abdominal surgery.

Key payers addressed in the analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a clinical and billing overview of the procedure, typical sites of service, and the context in which the code is used. The content highlights how the code aligns with high-complexity open abdominal surgery and what aspects influence coding choice, such as lesion size thresholds specified in the descriptor.

This publication provides benchmarks and policy context relevant to payers and surgical providers, including common modifier usage and typical service-line considerations. It also outlines areas where documentation must support the use of 49190, and summarizes payer coverage patterns and coding implications at a national level. Data not available in the input is identified explicitly where applicable.