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CPT code 49406: Catheter drainage, peritoneal or retroperitoneal2026 Medicare rate & RVUs in Washington, DC area

Report percutaneous, image-guided catheter placement to drain a fluid collection in the peritoneal or retroperitoneal space.

CMS RVU26DEffective Oct 1, 2026One payment locality27.5K Medicare services in 2024

In Washington, DC area, Medicare pays $968.95 for 49406 in the office and $179.27 when it’s performed in a hospital or facility.

$968.95Office (non-facility)
$179.27Hospital or facility
+15.8%vs the national office rate ($837.03)

Check a contract rate as a % of Medicare · 49406 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 49406 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 49406 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 49406 covers

This service places a catheter through the skin into a fluid collection in the peritoneal or retroperitoneal space so the collection can be drained. Typical cases include image-guided drainage of an abdominal abscess, hematoma, or cyst. An interventional radiologist commonly performs the procedure in a hospital imaging suite or other procedural setting, using imaging to guide access and catheter position.

Select this code when the collection is peritoneal or retroperitoneal; collections in a visceral organ or another specified access route belong to different codes. The report should identify the collection’s location and nature, the imaging guidance and access used, and catheter placement and drainage. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued is paid in full and the others are subject to the standard 50% reduction. 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.

How Washington, DC area compares for 49406

Across 109 of 109 payment localities, the office rate for 49406 runs from $732.55 in Arkansas to $1,151.04 in San Benito County, CA. Washington, DC area pays $968.95. The RVUs are the same everywhere; the geographic indexes change the dollars.

49406 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$968.95
  2. Los Angeles, CA · California$964.42−$4.53
  3. Miami, FL · Florida$886.88−$82.07
  4. Chicago, IL · Illinois$859.57−$109.38
  5. Manhattan, NY · New York$965.81−$3.14
  6. Alaska · Alaska$940.89−$28.06
  7. Alabama · Alabama$744.35−$224.60

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

49406 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$732.55$156.71
ArizonaArizona$813.53$163.96
Bakersfield, CACalifornia$900.52$165.81
Chico, CACalifornia$899.23$164.52
El Centro, CACalifornia$899.30$164.59
Fresno, CACalifornia$899.23$164.52
Hanford, CACalifornia$899.23$164.52
Madera, CACalifornia$899.23$164.52

49406 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$732.55

$1,025.14

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
49406 office rate range by state
State / territoryOffice rate rangeLocalities
AK$940.891
AL$744.351
AR$732.551
AZ$813.531
CA$899.23–$1,151.0429
CO$879.851
CT$895.921
DC$968.951
DE$827.951
FL$813.60–$886.883
GA$764.90–$851.322
GU$926.031
HI$926.031
IA$769.681
ID$774.211
IL$784.66–$867.474
IN$779.251
KS$763.571
KY$758.941
LA$756.77–$798.062
MA$872.98–$975.212
MD$845.49–$968.953
ME$776.31–$825.622
MI$778.57–$822.402
MN$847.241
MO$741.06–$803.803
MS$737.081
MT$837.001
NC$785.551
ND$828.691
NE$774.961
NH$863.681
NJ$907.33–$957.022
NM$782.351
NV$835.381
NY$798.22–$988.315
OH$776.871
OK$759.781
OR$830.09–$912.412
PA$779.45–$870.482
PR$844.441
RI$860.851
SC$782.271
SD$827.711
TN$767.491
TX$773.68–$875.878
UT$794.031
VA$821.13–$968.952
VI$844.441
VT$823.171
WA$872.08–$998.222
WI$798.221
WV$752.321
WY$833.381

See 49406 in every payment locality

How the 49406 rate is calculated

Each of 49406’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 · 49406

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.90

3.90 RVUs× 1.000 GPCI

Practice expense20.74

20.74 RVUs× 1.000 GPCI

Malpractice0.42

0.42 RVUs× 1.000 GPCI

Adjusted RVUs

25.0600

Conversion factor

$33.4009

Medicare rate

$837.03

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,795

Code
49406
Physician work
3.90
Practice expense
20.74
Malpractice
0.42

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 49406 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work3.90× 1.0544.1106
Practice expense20.74× 1.17824.4317
Malpractice0.42× 1.1130.4675
Total RVUs29.0098
Conversion factor× 33.4009

Office rate, Washington, DC area$968.95

Office: (3.9 × 1.054 + 20.74 × 1.178 + 0.42 × 1.113) × $33.4009 = $968.95

Facility: (3.9 × 1.054 + 0.67 × 1.178 + 0.42 × 1.113) × $33.4009 = $179.27

Open 49406 in the RVU calculator

Payment rules and modifiers for 49406

The CMS indicators that decide how 49406 is paid alongside other services.

CMS payment indicators · 49406

Catheter drainage, peritoneal or retroperitoneal

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49406 without 51 · national office

$837.03

Catheter drainage, peritoneal or retroperitoneal

49406-51 · Second procedure: 50%

$418.52

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%).

When to use modifier 51

Codes related to 49406

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 49406
CodeHow it relatesOffice range, Washington, DC area
Same family
49405Visceral drainage, percutaneous catheter placementSibling code for image-guided catheter drainage of a visceral fluid collection.$969.74
49407Pelvic drainage, transvaginal or transrectalSibling code for drainage reached through a transvaginal or transrectal route.$849.72
Used instead
49083Paracentesis, with imaging guidanceImage-guided abdominal paracentesis for fluid removal without placement of a drainage catheter.$326.30

How 49406 has changed in Washington, DC area

49406 · Office / nonfacility

$968.95

Effective 2026-10-01

The base rate is $4.29 higher than on 2025-10-01, moving from $964.66 to $968.95 (0.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $964.66changed to$968.95

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.00 changed to 3.90
    • Practice expense RVU 21.08 changed to 20.74
    • Malpractice RVU 0.40 changed to 0.42
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1017.72changed to$964.66

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 21.71 changed to 21.08

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1001.11changed to$1017.72

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1082.97changed to$1001.11

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 22.46 changed to 21.71
    • Malpractice RVU 0.38 changed to 0.40
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $1147.50changed to$1082.97

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 23.05 changed to 22.46
    • Malpractice RVU 0.35 changed to 0.38
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1153.97changed to$1147.50

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 22.99 changed to 23.05
    • Malpractice RVU 0.34 changed to 0.35

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1083.22changed to$1153.97

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 20.79 changed to 22.99
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1016.42changed to$1083.22

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 19.57 changed to 20.79
    • Malpractice RVU 0.35 changed to 0.34
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $973.21changed to$1016.42

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 18.61 changed to 19.57
    • Malpractice RVU 0.34 changed to 0.35

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $969.49changed to$973.21

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 18.57 changed to 18.61
    • Malpractice RVU 0.35 changed to 0.34
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1052.71changed to$969.49

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 4.25 changed to 4.00
    • Practice expense RVU 20.30 changed to 18.57
    • Malpractice RVU 0.37 changed to 0.35
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1056.24changed to$1052.71

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 20.23 changed to 20.30
    • Malpractice RVU 0.43 changed to 0.37

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $1050.98changed to$1056.24

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1041.75changed to$1050.98

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 20.11 changed to 20.23
    • Malpractice RVU 0.37 changed to 0.43
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$1041.75

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$968.95$179.27RVU26D
2026-07-01$968.95$179.27RVU26C
2026-04-01$968.95$179.27RVU26B
2026-01-01$968.95$179.27RVU26A
2025-10-01$964.66$202.38RVU25D
2025-07-01$964.66$202.38RVU25C
2025-04-01$964.66$202.38RVU25B
2025-01-01$964.66$202.38RVU25A
2024-10-01$1,017.72$206.68RVU24D
2024-07-01$1,017.72$206.68RVU24C
2024-04-01$1,017.72$206.68RVU24B
2024-03-09$1,017.72$206.68RVU24AR
2024-01-01$1,001.11$203.31RVU24A
2023-10-01$1,082.97$212.47RVU23D
2023-07-01$1,082.97$212.47RVU23C
2023-04-01$1,082.97$212.47RVU23B
2023-01-01$1,082.97$212.47RVU23A
2022-10-01$1,147.50$217.18RVU22D
2022-07-01$1,147.50$217.18RVU22C
2022-04-01$1,147.50$217.18RVU22B
2022-01-01$1,147.50$217.18RVU22A
2021-10-01$1,153.97$219.39RVU21D
2021-07-01$1,153.97$219.39RVU21C
2021-04-01$1,153.97$219.39RVU21B
2021-01-01$1,153.97$219.39RVU21A
2020-10-01$1,083.22$227.03RVU20D
2020-07-01$1,083.22$227.03RVU20C
2020-04-01$1,083.22$227.03RVU20B
2020-01-01$1,083.22$227.03RVU20A
2019-10-01$1,016.42$226.04RVU19D
2019-07-01$1,016.42$226.04RVU19C
2019-04-01$1,016.42$226.04RVU19B
2019-01-01$1,016.42$226.04RVU19A
2018-10-01$973.21$225.78RVU18D
2018-07-01$973.21$225.78RVU18C
2018-04-01$973.21$225.78RVU18B
2018-01-01$973.21$225.78RVU18AR1
2017-10-01$969.49$227.82RVU17D
2017-07-01$969.49$227.82RVU17C
2017-04-01$969.49$227.82RVU17B
2017-01-01$969.49$227.82RVU17A
2016-10-01$1,052.71$242.46RVU16D
2016-07-01$1,052.71$242.46RVU16C
2016-04-01$1,052.71$242.46RVU16B
2016-01-01$1,052.71$242.46RVU16A
2015-10-01$1,056.24$246.10RVU15D
2015-07-01$1,056.24$246.10RVU15C
2015-04-01$1,050.98$244.88RVU15B
2015-01-01$1,050.98$244.88RVU15A
2014-10-01$1,041.75$242.14RVU14D
2014-07-01$1,041.75$242.14RVU14C
2014-04-01$1,041.75$242.14RVU14B
2014-01-01$1,041.75$242.14RVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 49406 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

49406 billing questions

How does this differ from 49405?

Use 49406 for a peritoneal or retroperitoneal collection. Code 49405 is for a collection in a visceral site, such as an organ.

When is 49407 more appropriate?

Code 49407 is for catheter drainage reached through a transvaginal or transrectal route. Code 49406 covers percutaneous drainage of a peritoneal or retroperitoneal collection.

Can the imaging guidance be billed separately?

Image guidance is part of this catheter-drainage service. The procedure documentation should identify the guidance used and how it directed access and catheter placement.

Can modifier 50 be used for collections on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

How does the multiple-procedure rule affect another procedure in the same session?

The highest-valued procedure is paid in full, and the other procedure or procedures are subject to the standard 50% reduction.

Is an assistant or co-surgeon payable for this procedure?

Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted.

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
RVUs for 49406PPRRVU2026_Oct_nonQPP.csv, line 5,795 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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