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    OpenPayerBilling CodesTunneled Intraperitoneal Catheter Insertion and Removal ProceduresCPT cpt-49421-peritoneal-dialysis-catheter-insertion
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    CPT 49421: Peritoneal Dialysis Catheter Placement

    Medicare pays $207 on average nationally for this procedure.

    CPT code 49421 describes the surgical insertion of a peritoneal dialysis catheter for patients with kidney disease who require dialysis; this is a surgical procedure (peritoneal dialysis catheter placement) typically performed in an operating room or procedure suite and is considered an inpatient or outpatient surgical service depending on clinical context and facility policies.

    For related coverage guidance, see recent payer policy updates: Surgical Procedures, Outpatient Surgical Procedures - Site of Service, Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient with end-stage renal disease (ESRD) secondary to diabetic nephropathy is scheduled for placement of a peritoneal dialysis catheter. The patient has been evaluated preoperatively in the nephrology clinic, cleared by internal medicine for anesthesia, and consented for the procedure. On the day of service the patient presents to the ambulatory surgery center (or hospital operating room for higher-risk cases). Under monitored anesthesia care or general anesthesia, the surgeon makes a small abdominal incision, creates a subcutaneous tunnel, and surgically inserts and secures a soft silicone peritoneal dialysis catheter into the peritoneal cavity, with confirmation of catheter position and flow. The catheter cuff is positioned in the subcutaneous tissue, incision sites are closed, and sterile dressings applied. Postoperative orders include peritoneal catheter care instructions, prophylactic antibiotics per facility protocol, hemostasis monitoring, and scheduling for initial dialysate training with the dialysis nurse. This procedure is performed when chronic dialysis is required and when tunneled peritoneal access is the chosen modality for renal replacement therapy. Typical site of service: Ambulatory surgery center or inpatient operating room. Service type: Surgical insertion of peritoneal dialysis catheter.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    49422Revision or removal of implanted peritoneal dialysis catheterPerformed if catheter malfunctions, requires repositioning, or needs removal due to infection or malfunction following initial placement
    49083Peritoneal dialysis catheter, mechanical assistance for placement (e.g., adhesion lysis)May be billed when significant adhesiolysis or additional mechanical assistance is required during placement
    49406Replacement, percutaneous, of long-term tunneled central venous catheter, without subcutaneous port or pumpOften part of dialysis access management workflow when hemodialysis catheters are needed instead of peritoneal access
    G0346Placement of tunneled intraperitoneal catheter for peritoneal dialysis (Medicare G-code where applicable)Alternate billing code used in some payer-specific policies for peritoneal dialysis catheter placement
    49568Repair incisional or ventral hernia; reducibleMay be performed concurrently if an abdominal wall defect is identified and repaired during catheter placement

    Related Modifiers

    11 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Showing 1–10 of 11

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2084P0800X
    207L00000X
    207K00000X
    261QD1600X
    163WP2201X
    163WM0705X
    363LP0222X
    208M00000X

    Related Payer Policy Updates

    Specialty: General Surgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Surgical ProceduresUnitedHealthcare2026-09-01
    Outpatient Surgical Procedures - Site of ServiceUnitedHealthcare2026-09-01
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01
    Medical Necessity Guidelines — Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Ambulatory Surgery Center (ASC) - Site of Care PolicyKaiser Permanente2026-08-01

    Related Codes

    CPT-49418-PERCUTANEOUS-TUNNELED-ABDOMINAL-CATHETER-PLACEMENT

    CPT 49418: Percutaneous Tunneled Abdominal Catheter Placement

    CPT-49419-INTRAPERITONEAL-CATHETER-WITH-SUBCUTANEOUS-RESERVOIR-IMPLANTATION

    CPT 49419: Intraperitoneal Catheter with Subcutaneous Reservoir Placement

    CPT-49422-TUNNELED-INTRAPERITONEAL-CATHETER-REMOVAL

    CPT 49422: Removal of Tunneled Intraperitoneal Catheter

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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