CPT code 49407: Pelvic drainage, transvaginal or transrectal2026 Medicare rate & RVUs in Texas
Reports image-guided catheter drainage of a pelvic fluid collection through a transvaginal or transrectal route, such as drainage of a deep pelvic abscess.
Medicare pays $683.28–$768.89 for 49407 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 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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$683.28 to $768.89
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $768.89 | $179.80 |
| Beaumont, TX | $683.28 | $176.60 |
| Brazoria, TX | $728.95 | $177.17 |
| Dallas, TX | $733.32 | $178.76 |
| Fort Worth, TX | $727.73 | $178.73 |
| Galveston, TX | $730.93 | $178.03 |
| Houston, TX | $740.26 | $187.37 |
| Rest of Texas | $705.51 | $177.12 |
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.
How the rate is built · 49407
RVUs × geographic indexes × conversion factor
Work4.14
4.14 RVUs× 1.000 GPCI
Practice expense17.41
17.41 RVUs× 1.000 GPCI
Malpractice0.51
0.51 RVUs× 1.000 GPCI
Adjusted RVUs
22.0600
Conversion factor
$33.4009
Medicare rate
$736.82
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49407
The CMS indicators that decide how 49407 is paid alongside other services.
CMS payment indicators · 49407
Pelvic drainage, transvaginal or transrectal
| 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
49407 without 51 · national office
$736.82
Pelvic drainage, transvaginal or transrectal
49407-51 · Second procedure: 50%
$368.41
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%).
49407 compared with similar codes
Compare codes · National
4 codes, side by side
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.
49407 billing questions
When should this code be selected instead of 49406?
Use this code when the catheter reaches the pelvic collection through a transvaginal or transrectal route. Code 49406 is for image-guided drainage of a peritoneal or retroperitoneal collection.
Does the code include image guidance?
Yes. Image guidance is part of this catheter drainage service; documentation should identify the guidance used and the catheter placement.
Can modifier 50 be used for drainage on both sides?
Modifier 50 is inappropriate for this service. Report the procedure based on the documented collection and transvaginal or transrectal access.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the other procedures performed in that session.
Is same-day recovery care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant or co-surgeon be billed?
CMS restricts assistant-at-surgery payment for this service and does not permit co-surgeon or team-surgery billing.
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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