CPT code 49406: Catheter drainage, peritoneal or retroperitoneal2026 Medicare rate & RVUs in Texas
Report percutaneous, image-guided catheter placement to drain a fluid collection in the peritoneal or retroperitoneal space.
Medicare pays $773.68–$875.87 for 49406 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 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.
Where 49406 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
$773.68 to $875.87
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $875.87 | $166.63 |
| Beaumont, TX | $773.68 | $163.66 |
| Brazoria, TX | $828.75 | $164.42 |
| Dallas, TX | $833.44 | $165.76 |
| Fort Worth, TX | $826.69 | $165.72 |
| Galveston, TX | $830.81 | $165.14 |
| Houston, TX | $838.49 | $172.83 |
| Rest of Texas | $800.34 | $164.17 |
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
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.
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
| 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
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%).
49406 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 49405Visceral drainagePercutaneous catheter placement
- Choose 49406 for a peritoneal or retroperitoneal collection; choose 49405 when the collection is in a visceral site.
- 49407Pelvic drainageTransvaginal or transrectal
- Code 49407 describes catheter drainage using a transvaginal or transrectal route, rather than percutaneous access to a peritoneal or retroperitoneal collection.
- 49083ParacentesisWith imaging guidance
- Code 49083 is for image-guided abdominal paracentesis. Use 49406 when a catheter is placed to drain a peritoneal or retroperitoneal collection.
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
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