Summary & Overview
CPT 49429: Removal of Peritoneal Venous Catheter
CPT code 49429 denotes the surgical removal of a peritoneal venous catheter via one or two small incisions. The code captures a focused explantation procedure for implanted peritoneal vascular access, a service relevant across surgical, oncology, and nephrology care pathways. Accurate coding for this procedure is important for claims processing, resource planning, and national procedure volume tracking.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and coding definition, typical sites of service, and the common payer mix for this type of procedure. The publication also outlines available national benchmarks, expected reimbursement considerations, and relevant policy or billing clarifications affecting evaluation and payment of this code. Clinical implications for perioperative management and documentation requirements tied to explantation are summarized to help stakeholders understand when and how the code is used.
Data not available in the input for detailed payer-specific rates, associated ICD-10 diagnoses, and provider taxonomies is noted where applicable. The content is intended for a national audience seeking a clear, practice-oriented summary of CPT code 49429.
Billing Code Overview
CPT code 49429 describes a procedure in which the provider makes one or two incisions to remove a peritoneal venous catheter. This service is a minor surgical procedure focused on explantation of an implanted vascular access device from the peritoneal cavity.
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Service type: Surgical removal of implanted peritoneal venous catheter
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Typical site of service: Ambulatory surgical center or hospital outpatient setting
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult receiving chronic peritoneal dialysis who requires removal of a tunneled peritoneal dialysis catheter due to malfunction, exit-site or tunnel infection unresponsive to conservative therapy, catheter migration, or conversion to hemodialysis. The patient presents to an outpatient ambulatory surgery center or hospital minor procedure suite for a focused procedure under local anesthesia with sedation or monitored anesthesia care. The provider makes one or two small incisions over the catheter cuff(s) to mobilize and extract the catheter from the subcutaneous tunnel and peritoneal cavity, achieves hemostasis, inspects the exit site for infection, evacuates any purulent material if present, and places dressings. Post-procedure, the patient is observed briefly and instructed on wound care and follow-up; infected cases may require culture-directed antibiotics and further surgical debridement if necessary.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier; standard reporting | Use when no special circumstances apply. |
| 11 | Anesthesia or medical direction? (commonly a payer-specific modifier indicating primary surgeon) | Use per payer policy when identifying the primary surgeon when required by the payer. |
| 22 | Increased procedural service | Use when the removal required substantially greater work than typical (extensive dissection, infected tunnel requiring debridement). |