Summary & Overview

CPT 49402: Surgical Removal of Abdominal Foreign Body

CPT code 49402 denotes surgical removal of a foreign body from the abdominal cavity, a procedure performed when non-native material is located within the peritoneal or retroperitoneal spaces. This code is used across hospital and ambulatory surgical settings and is clinically important because timely and appropriate removal can prevent infection, organ injury, and other complications. Nationally, the code is relevant to surgical quality reporting and inpatient/outpatient billing patterns for abdominal surgical services.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the clinical scenario associated with the code, expected sites of service, and common billing context. The publication outlines expected benchmarks where available, typical payer coverage patterns, and relevant coding considerations for operative abdominal procedures. It also provides clinical context about indications and potential service settings to help billing, clinical, and administrative staff align coding with documentation.

Data not available in the input: associated taxonomies, specific ICD-10 diagnoses, related codes, and service-line detail. The report is intended for a national audience and summarizes the core clinical meaning, payer coverage scope, and what users can expect to learn about coding and billing for this abdominal surgical procedure.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare49402CPTabdominal surgeryforeign body removaloperative procedurehospital servicesambulatory surgerysurgical coding

Billing Code Overview

CPT code 49402 describes a surgical procedure in which the provider removes a foreign body from within the abdominal cavity. This is an operative abdominal service involving exploration and extraction of non-native material from the peritoneal or retroperitoneal space.

Service type: Surgical foreign body removal (abdominal)
Typical site of service: Hospital operating room or ambulatory surgery center

Clinical & Coding Specifications

Clinical Context

A 42-year-old male presents to the emergency department after abdominal trauma with increasing abdominal pain, distension, and signs of peritonitis. Imaging (abdominal CT) demonstrates a radiopaque foreign object within the peritoneal cavity consistent with an ingested or penetrating foreign body and associated localized inflammatory change. The surgical team evaluates the patient and schedules an operative procedure for removal of the foreign body from the abdominal cavity using an open or laparoscopic approach.

Clinical workflow:

Initial evaluation in the emergency department with focused history and physical exam, hemodynamic stabilization, and laboratory tests.
Diagnostic imaging (plain abdominal radiograph and CT scan) to localize the foreign body and assess for perforation, abscess, or hemoperitoneum.
Preoperative consent, anesthesia evaluation, and perioperative antibiotics as indicated.
Operative removal of the foreign body from the abdominal cavity under general anesthesia using CPT 49402 (surgical removal of foreign body, intra-abdominal).
Intraoperative decision-making regarding laparoscopic versus open approach, management of any contamination or organ injury, and placement of drains if needed.
Postoperative monitoring in the post-anesthesia care unit with inpatient admission if indicated for observation, repeat imaging, wound care, or management of concurrent injuries or infection.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the work required to remove the foreign body is substantially greater than typical for `CPT 49402`, documented with supporting operative and anesthesia notes.
`23`	Unusual anesthesia	Use when general anesthesia is medically contraindicated and alternative anesthesia is provided under unusual circumstances.
`26`	Professional component	Use if billing is split and only the professional portion of a physician-read service is being billed (rare for `CPT 49402`).
`50`	Bilateral procedure	Use when identical foreign bodies are surgically removed from bilateral intra-abdominal sites in a single operative session and payer allows bilateral reporting.
`51`	Multiple procedures	Use when `CPT 49402` is performed with other distinct procedures during the same operative session; append modifier to secondary procedures per payer rules.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned (e.g., aborted removal due to instability).
`53`	Discontinued procedure	Use when the procedure is started but discontinued prior to completion for patient safety reasons.
`59`	Distinct procedural service	Use when `CPT 49402` is performed in a separate session or distinct anatomic site from other procedures on the same date.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons due to complexity of the foreign-body removal and both are billing.
`66`	Surgical team	Use when a documented surgical team approach is required and allowed by payer.
`73`	Discontinued outpatient procedure prior to anesthesia	Use if the outpatient removal was discontinued prior to anesthesia induction.
`78`	Return to OR for related procedure during global period	Use when patient returns to the operating room for a related intra-abdominal complication of the foreign-body removal during the global period.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated intra-abdominal procedure is performed during the global period (note: `79` is not in the provided list; do not use it).

Modifier

Description

When to Use

22

Increased procedural services

Use when the work required to remove the foreign body is substantially greater than typical for CPT 49402, documented with supporting operative and anesthesia notes.

23

Unusual anesthesia

Use when general anesthesia is medically contraindicated and alternative anesthesia is provided under unusual circumstances.

26

Professional component

Use if billing is split and only the professional portion of a physician-read service is being billed (rare for CPT 49402).

50

Bilateral procedure

Use when identical foreign bodies are surgically removed from bilateral intra-abdominal sites in a single operative session and payer allows bilateral reporting.

51

Multiple procedures

Use when CPT 49402 is performed with other distinct procedures during the same operative session; append modifier to secondary procedures per payer rules.

52

Reduced services

Use when the procedure is partially reduced or not completed as planned (e.g., aborted removal due to instability).

53

Discontinued procedure

Use when the procedure is started but discontinued prior to completion for patient safety reasons.

59

Distinct procedural service

Use when CPT 49402 is performed in a separate session or distinct anatomic site from other procedures on the same date.

62

Two surgeons

Use when two surgeons work together as primary surgeons due to complexity of the foreign-body removal and both are billing.

66

Surgical team

Use when a documented surgical team approach is required and allowed by payer.

73

Discontinued outpatient procedure prior to anesthesia

Use if the outpatient removal was discontinued prior to anesthesia induction.

78

Return to OR for related procedure during global period

Use when patient returns to the operating room for a related intra-abdominal complication of the foreign-body removal during the global period.

79

Unrelated procedure or service by the same physician during the postoperative period

Use when an unrelated intra-abdominal procedure is performed during the global period (note: 79 is not in the provided list; do not use it).

Taxonomy Code	Specialty	Notes
207L00000X	General Surgery	General surgeons commonly perform intra-abdominal foreign body removals.
207RG0300X	Surgical Critical Care	Surgical intensivists manage complex trauma patients and may participate in operative removal.
2080P0222X	Pediatric Surgery	Pediatric surgeons perform similar procedures in children when applicable.
208800000X	Emergency Medicine	Emergency physicians frequently initiate evaluation and stabilization prior to operative management.
207XS0110X	Colon and Rectal Surgery	Colorectal surgeons may be involved if the foreign body involves the distal colon or rectum.

ICD-10 Code	Description	Clinical Relevance
`K63.1`	Perforation of intestine (nontraumatic)	Foreign bodies that perforate the bowel can require intra-abdominal removal and repair.
`K56.69`	Other intestinal obstruction	Impacted foreign bodies can cause mechanical bowel obstruction necessitating surgical retrieval.
`T18.1`	Foreign body in esophagus	If an ingested foreign body transits into the abdominal cavity via perforation or migration, removal from the abdomen may be required.
`T18.2`	Foreign body in stomach	Large or sharp gastric foreign bodies that have migrated or perforated may be retrieved intra-abdominally.
`T81.89`	Other complications of procedures, not elsewhere classified	Used when postoperative complications related to retained foreign bodies or operative retrieval occur.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`49000`	Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)	May be performed to access the abdominal cavity when open removal of a foreign body is required; often precedes or is combined with `CPT 49402` when exploration is needed.
`49505`	Repair of incisional or ventral hernia; reducible, any size with or without mesh	May be performed during the same operative session if a prior fascial defect is encountered or created during foreign-body removal.
`44204`	Laparoscopy, surgical, enterolysis (separate procedure)	Laparoscopic adhesiolysis may be performed concurrently if dense adhesions are encountered while retrieving a foreign body.
`44120`	Enterectomy, resection of small intestine, single resection and anastomosis	Performed if intestinal injury or necrosis from the foreign body necessitates resection during the procedure.
`49560`	Repair of incarcerated or strangulated hernia; initial incision of the hernia sac may be necessary if a foreign body has translocated through a hernia defect	Relevant when the foreign body is associated with or has migrated through a hernia requiring concurrent repair.
`10160`	Puncture aspiration of abscess; single or multiple	May be performed preoperatively or postoperatively for localized intra-abdominal abscess associated with the foreign body; often image-guided by interventional radiology.

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