CPT code 49405: Visceral drainage, percutaneous catheter placement2026 Medicare rate & RVUs in Texas
Reports image-guided percutaneous catheter drainage of a collection within a visceral organ, such as an abscess or cyst, in the peritoneal or retroperitoneal region.
Medicare pays $774.29–$876.57 for 49405 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 49405 covers
A physician, commonly an interventional radiologist, uses imaging to guide a catheter through the skin into a fluid collection within a visceral organ and establish drainage. A typical example is catheter drainage of a liver abscess. The procedure is generally performed in a hospital or other imaging suite, with the catheter left in place to drain the collection as clinically indicated.
Select this service when the collection is within a visceral structure; a collection located in the peritoneal or retroperitoneal space is distinguished by the target anatomy. Document the collection’s location, the percutaneous approach, image guidance, and catheter placement. Imaging guidance is included in the drainage service. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 49405 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$774.29 to $876.57
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $876.57 | $166.63 |
| Beaumont, TX | $774.29 | $163.66 |
| Brazoria, TX | $829.41 | $164.42 |
| Dallas, TX | $834.10 | $165.76 |
| Fort Worth, TX | $827.35 | $165.72 |
| Galveston, TX | $831.47 | $165.14 |
| Houston, TX | $839.16 | $172.83 |
| Rest of Texas | $800.97 | $164.17 |
How the 49405 rate is calculated
Each of 49405’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 49405
RVUs × geographic indexes × conversion factor
Work3.90
3.90 RVUs× 1.000 GPCI
Practice expense20.76
20.76 RVUs× 1.000 GPCI
Malpractice0.42
0.42 RVUs× 1.000 GPCI
Adjusted RVUs
25.0800
Conversion factor
$33.4009
Medicare rate
$837.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49405
The CMS indicators that decide how 49405 is paid alongside other services.
CMS payment indicators · 49405
Visceral drainage, percutaneous catheter placement
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49405 without 51 · national office
$837.69
Visceral drainage, percutaneous catheter placement
49405-51 · Second procedure: 50%
$418.85
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
49405 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 49406Catheter drainagePeritoneal or retroperitoneal
- Choose 49405 when the collection is within a visceral organ. Choose 49406 when the target is a collection in the peritoneal or retroperitoneal space.
- 49407Pelvic drainageTransvaginal or transrectal
- 49407 describes collection drainage through a transvaginal or transrectal route. This code describes percutaneous catheter drainage of a visceral collection.
- 49423Drain catheter exchangeFluoroscopic exchange
- 49423 is for exchanging a drainage catheter already in place. This code is for image-guided percutaneous catheter drainage of a visceral collection.
49405 billing questions
How is this code distinguished from 49406?
Use 49405 for a collection within a visceral organ. Code 49406 is for a peritoneal or retroperitoneal collection rather than a collection within a visceral structure.
Is imaging guidance separately reported?
No. Imaging guidance is included in this drainage service.
What documentation supports code selection?
Document the collection’s anatomic location, percutaneous access, use of imaging guidance, and catheter placement. The record should make clear that the target is within a visceral organ.
Does the service have a global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for this code.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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