CPT code 49423: Drain catheter exchange, fluoroscopic exchange2026 Medicare rate & RVUs

Medicare pays $549.44 for 49423 nationally in the office and $60.79 in a hospital or facility. Local office rates run $476.82–$771.71.

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

What 49423 covers

This service exchanges an existing percutaneous catheter used to drain a fluid collection, such as an abscess, hematoma, seroma, or cyst. An interventional radiologist typically removes the existing catheter and places a replacement through the established access, using fluoroscopy and contrast injection to assess the catheter and collection. The procedure is commonly performed in a hospital radiology suite or another setting equipped for image-guided intervention.

Report the exchange when a catheter is already in place and is replaced, rather than when a new drainage catheter is initially placed. The record should identify the collection and existing catheter, explain the reason for exchange, and document the replacement and imaging. Contrast injection and fluoroscopic guidance with radiological supervision and interpretation are included. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 49423 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

49423 rates by state

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

How the 49423 rate is calculated

Each of 49423’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 49423

The CMS indicators that decide how 49423 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

49423 compared with similar codes

How to choose

49405Visceral drainagePercutaneous catheter placement

49405 reports placement of a new catheter to drain a visceral collection. Use 49423 when an existing percutaneous drainage catheter is exchanged.

49406Catheter drainagePeritoneal or retroperitoneal

49406 is for new catheter placement in a peritoneal or retroperitoneal collection. It does not describe replacement of a catheter already in place.

49407Pelvic drainageTransvaginal or transrectal

49407 describes new catheter placement through a transrectal or transvaginal route. 49423 describes exchange of an existing percutaneous drainage catheter.

49424Cavity contrast studyExisting abscess, cyst, or tract

49424 covers contrast evaluation through an existing drainage catheter without an exchange. 49423 is reported when the catheter itself is replaced.

Codes related to 49423

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