CPT code 49407: Pelvic drainage, transvaginal or transrectal2026 Medicare rate & RVUs

Medicare pays $736.82 for 49407 nationally in the office and $180.03 in a hospital or facility. Local office rates run $646.57–$1,001.16.

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

What 49407 covers

This service places a drainage catheter into a pelvic fluid collection using a transvaginal or transrectal approach and image guidance. Interventional radiologists commonly perform it in a hospital or other facility for collections that can be accessed through the vagina or rectum, including selected postoperative pelvic abscesses. The catheter provides ongoing drainage; needle aspiration alone is not the defining service.

Choose this code when the documented access route is transvaginal or transrectal, rather than selecting a code for a visceral, peritoneal, or retroperitoneal collection. The report should identify the collection, its location, the access route, image guidance, and catheter placement. The code includes the image-guided drainage service. CMS assigns 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 the others are subject to the standard 50% reduction. CMS restricts assistant-at-surgery payment and does not permit co-surgeon or team-surgery billing for this service.

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 49407 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

49407 rates by state

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

How the 49407 rate is calculated

Each of 49407’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.

Payment rules and modifiers for 49407

The CMS indicators that decide how 49407 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

49407 compared with similar codes

How to choose

49405Visceral drainagePercutaneous catheter placement

49405 addresses drainage of a visceral collection. This code is selected for a pelvic collection accessed transvaginally or transrectally.

49406Catheter drainagePeritoneal or retroperitoneal

49406 is for a peritoneal or retroperitoneal collection. Select this code when the documented access is transvaginal or transrectal.

49020Abscess drainageOpen peritoneal approach

49020 describes open surgical drainage of a peritoneal abscess. This code describes image-guided catheter drainage through a transvaginal or transrectal route.

Codes related to 49407

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

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

Open CMS sourceHow we calculate rates