CPT
43239 — Upper GI endoscopy with biopsy
High-volume procedure with predictable surprise-bill risk.
Gastroenterology
49083 — Abdominal paracentesis, with imaging guidance
This code covers the drainage of fluid from the abdominal cavity (the peritoneal space) using a needle or catheter, guided by ultrasound imaging to ensure safe placement.
- Typical setting: Endoscopy suite, hospital
- National avg charge (illustrative): $175-$380 Medicare allowed (approx. $190-$310 national Medicare average)
- Most-disputed reason: Separate billing of ultrasound guidance: the imaging guidance is already included in 49083 — separately billing ultrasound code 76942 on the same day constitutes unbundling
What it means
What 49083 actually means
This code covers the drainage of fluid from the abdominal cavity (the peritoneal space) using a needle or catheter, guided by ultrasound imaging to ensure safe placement. Paracentesis is performed for conditions like liver cirrhosis or cancer that cause fluid buildup (ascites). The imaging guidance component (ultrasound) is included in this code.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Separate billing of ultrasound guidance: the imaging guidance is already included in 49083 — separately billing ultrasound code 76942 on the same day constitutes unbundling
- Billing 49082 vs. 49083: if paracentesis was performed without imaging guidance, use 49082 — billing the imaging-guided code when no imaging was documented is upcoding
- Facility fee duplication: patients receiving both a physician bill and a facility/hospital bill for paracentesis is expected (professional vs. technical component), but identical duplicate charges from the same entity are an error
If you see 49083 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 49083 often also see these adjacent codes on the same bill.
CPT
43644 — Laparoscopic Roux-en-Y gastric bypass with small intestine reconstruction
Verify the code matches the actual service and dose.
CPT
45378 — Diagnostic colonoscopy
If your screening colonoscopy turned diagnostic, federal rules limit your cost-share.
CPT
45380 — Colonoscopy, flexible, with biopsy, single or multiple
Verify the code matches the actual service and dose.
Related BillBusted guides
Plain-English reads if you see 49083 on a bill.
49083 FAQ
Plain-English answers.
What does 49083 usually cost?
$175-$380 Medicare allowed (approx. $190-$310 national Medicare average). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 49083?
Separate billing of ultrasound guidance: the imaging guidance is already included in 49083 — separately billing ultrasound code 76942 on the same day constitutes unbundling
What should I do if I see 49083 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 49083 before paying.
Don't pay 49083 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.