CPT code 49446 denotes a fluoroscopically guided, percutaneous conversion of an existing gastrostomy tube to a gastrojejunostomy tube. This interventional procedure is used when patients with established gastrostomy access cannot tolerate gastric feeding and require post-pyloric enteral delivery into the jejunum. Nationally, the code captures a specific image-guided enteral access conversion that spans inpatient and outpatient interventional settings and has implications for clinical pathways, utilization oversight, and payer coverage policies.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for tube conversion, typical sites of service, and common billing considerations. The publication summarizes benchmark utilization patterns, relevant policy and coverage trends affecting reimbursement and prior authorization, and the clinical scenarios that commonly lead to use of this code. Where input data is missing, the publication notes those gaps explicitly. This resource is intended for revenue cycle leaders, interventionalists, and policy analysts seeking a national-level briefing on coding, clinical context, and payer considerations for CPT code 49446.