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

Reports image-guided catheter drainage of a pelvic fluid collection through a transvaginal or transrectal route, such as drainage of a deep pelvic abscess.

CMS RVU26DEffective Oct 1, 2026One payment locality115 Medicare services in 2024

In Virginia, Medicare pays $721.93 for 49407 in the office and $174.60 when it’s performed in a hospital or facility.

$721.93Office (non-facility)
$174.60Hospital or facility
−2.0%vs the national office rate ($736.82)

Check a contract rate as a % of Medicare · 49407 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 49407 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 49407 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 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.

How Virginia compares for 49407

Across 109 of 109 payment localities, the office rate for 49407 runs from $646.57 in Arkansas to $1,001.16 in San Benito County, CA. Virginia pays $721.93. The RVUs are the same everywhere; the geographic indexes change the dollars.

49407 in Virginia vs other payment areas
  1. Virginia · this page$721.93
  2. Los Angeles, CA · California$843.19+$121.26
  3. Washington, DC area · District of Columbia$849.72+$127.79
  4. Miami, FL · Florida$786.71+$64.78
  5. Chicago, IL · Illinois$762.76+$40.83
  6. Manhattan, NY · New York$849.86+$127.93
  7. Alaska · Alaska$836.11+$114.18

Other areas in Virginia first, then benchmark localities. Bars start at $0.

Every other payment area

49407 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$656.74$169.55
ArkansasArkansas$646.57$168.28
ArizonaArizona$716.34$176.81
Bakersfield, CACalifornia$788.62$178.37
Chico, CACalifornia$787.10$176.85
El Centro, CACalifornia$787.18$176.94
Fresno, CACalifornia$787.10$176.85
Hanford, CACalifornia$787.10$176.85

49407 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.

$646.57

$894.13

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

View every state and territory as a table
49407 office rate range by state
State / territoryOffice rate rangeLocalities
AK$836.111
AL$656.741
AR$646.571
AZ$716.341
CA$787.10–$1,001.1629
CO$771.971
CT$787.941
DC$849.721
DE$728.821
FL$719.81–$786.713
GA$677.29–$749.972
GU$809.321
HI$809.321
IA$677.121
ID$681.331
IL$695.82–$766.644
IN$685.621
KS$672.551
KY$670.831
LA$669.23–$704.832
MA$766.40–$853.432
MD$743.79–$849.723
ME$683.86–$725.302
MI$688.43–$728.162
MN$741.701
MO$656.13–$708.953
MS$651.551
MT$736.791
NC$691.711
ND$726.711
NE$681.451
NH$758.541
NJ$797.51–$839.742
NM$691.981
NV$734.561
NY$702.69–$870.185
OH$686.371
OK$670.801
OR$729.44–$799.222
PA$688.20–$766.442
PR$742.961
RI$756.801
SC$690.071
SD$725.511
TN$676.021
TX$683.28–$768.898
UT$700.201
VA$721.93–$849.722
VI$742.961
VT$722.591
WA$765.37–$872.622
WI$700.611
WV$667.991
WY$732.391

See 49407 in every payment locality

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

Office or facility?

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.

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,796

Code
49407
Physician work
4.14
Practice expense
17.41
Malpractice
0.51

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 49407 in Virginia
ComponentRVULocality factorAdjusted
Physician work4.14× 1.0004.1400
Practice expense17.41× 0.98317.1140
Malpractice0.51× 0.7060.3601
Total RVUs21.6141
Conversion factor× 33.4009

Office rate, Virginia$721.93

Office: (4.14 × 1 + 17.41 × 0.983 + 0.51 × 0.706) × $33.4009 = $721.93

Facility: (4.14 × 1 + 0.74 × 0.983 + 0.51 × 0.706) × $33.4009 = $174.60

Open 49407 in the RVU calculator

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

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

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%).

When to use modifier 51

Codes related to 49407

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

Codes related to 49407
CodeHow it relatesOffice range, Virginia
Same family
49405Visceral drainage, percutaneous catheter placementSibling image-guided catheter drainage code for a visceral fluid collection.$821.78
49406Catheter drainage, peritoneal or retroperitonealSibling image-guided catheter drainage code for a peritoneal or retroperitoneal collection.$821.13
Used instead
49020Abscess drainage, open peritoneal approachOpen drainage may be used for a peritoneal abscess when a percutaneous route is not selected.No office rate

How 49407 has changed in Virginia

49407 · Office / nonfacility

$721.93

Effective 2026-10-01

The base rate is $28.90 higher than on 2025-10-01, moving from $693.03 to $721.93 (4.2%).

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

    $693.03changed to$721.93

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.25 changed to 4.14
    • Practice expense RVU 17.07 changed to 17.41
    • Malpractice RVU 0.49 changed to 0.51
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $728.67changed to$693.03

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 17.55 changed to 17.07
    • Malpractice RVU 0.48 changed to 0.49

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $716.77changed to$728.67

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $759.54changed to$716.77

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 17.98 changed to 17.55
    • Malpractice RVU 0.44 changed to 0.48
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $793.37changed to$759.54

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 18.40 changed to 17.98
    • Malpractice RVU 0.41 changed to 0.44
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $787.42changed to$793.37

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 18.03 changed to 18.40
    • Malpractice RVU 0.42 changed to 0.41

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $738.62changed to$787.42

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 15.99 changed to 18.03
    • Malpractice RVU 0.41 changed to 0.42
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $691.46changed to$738.62

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 14.78 changed to 15.99
    • Malpractice RVU 0.40 changed to 0.41
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $659.46changed to$691.46

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 13.90 changed to 14.78

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $658.45changed to$659.46

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 13.96 changed to 13.90
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $732.13changed to$658.45

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 4.50 changed to 4.25
    • Practice expense RVU 15.83 changed to 13.96
    • Malpractice RVU 0.47 changed to 0.40
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $736.30changed to$732.13

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 15.89 changed to 15.83
    • Malpractice RVU 0.45 changed to 0.47

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $732.64changed to$736.30

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $734.05changed to$732.64

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 16.00 changed to 15.89
    • Malpractice RVU 0.40 changed to 0.45
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$734.05

    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$721.93$174.60RVU26D
2026-07-01$721.93$174.60RVU26C
2026-04-01$721.93$174.60RVU26B
2026-01-01$721.93$174.60RVU26A
2025-10-01$693.03$192.05RVU25D
2025-07-01$693.03$192.05RVU25C
2025-04-01$693.03$192.05RVU25B
2025-01-01$693.03$192.05RVU25A
2024-10-01$728.67$195.74RVU24D
2024-07-01$728.67$195.74RVU24C
2024-04-01$728.67$195.74RVU24B
2024-03-09$728.67$195.74RVU24AR
2024-01-01$716.77$192.55RVU24A
2023-10-01$759.54$200.96RVU23D
2023-07-01$759.54$200.96RVU23C
2023-04-01$759.54$200.96RVU23B
2023-01-01$759.54$200.96RVU23A
2022-10-01$793.37$205.60RVU22D
2022-07-01$793.37$205.60RVU22C
2022-04-01$793.37$205.60RVU22B
2022-01-01$793.37$205.60RVU22A
2021-10-01$787.42$208.66RVU21D
2021-07-01$787.42$208.66RVU21C
2021-04-01$787.42$208.66RVU21B
2021-01-01$787.42$208.66RVU21A
2020-10-01$738.62$216.46RVU20D
2020-07-01$738.62$216.46RVU20C
2020-04-01$738.62$216.46RVU20B
2020-01-01$738.62$216.46RVU20A
2019-10-01$691.46$216.36RVU19D
2019-07-01$691.46$216.36RVU19C
2019-04-01$691.46$216.36RVU19B
2019-01-01$691.46$216.36RVU19A
2018-10-01$659.46$216.48RVU18D
2018-07-01$659.46$216.48RVU18C
2018-04-01$659.46$216.48RVU18B
2018-01-01$659.46$216.48RVU18AR1
2017-10-01$658.45$217.63RVU17D
2017-07-01$658.45$217.63RVU17C
2017-04-01$658.45$217.63RVU17B
2017-01-01$658.45$217.63RVU17A
2016-10-01$732.13$232.00RVU16D
2016-07-01$732.13$232.00RVU16C
2016-04-01$732.13$232.00RVU16B
2016-01-01$732.13$232.00RVU16A
2015-10-01$736.30$232.60RVU15D
2015-07-01$736.30$232.60RVU15C
2015-04-01$732.64$231.44RVU15B
2015-01-01$732.64$231.44RVU15A
2014-10-01$734.05$230.63RVU14D
2014-07-01$734.05$230.63RVU14C
2014-04-01$734.05$230.63RVU14B
2014-01-01$734.05$230.63RVU14A
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 49407 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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
RVUs for 49407PPRRVU2026_Oct_nonQPP.csv, line 5,796 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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