FeeBase
Log inGet started
Menu

CPT code 49423: Drain catheter exchange, fluoroscopic exchange2026 Medicare rate & RVUs in Washington, DC area

Report this service when an existing percutaneous catheter draining an abscess, hematoma, seroma, or cyst is exchanged under fluoroscopic guidance.

CMS RVU26DEffective Oct 1, 2026One payment locality8.1K Medicare services in 2024

In Washington, DC area, Medicare pays $641.02 for 49423 in the office and $65.38 when it’s performed in a hospital or facility.

$641.02Office (non-facility)
$65.38Hospital or facility
+16.7%vs the national office rate ($549.44)

Check a contract rate as a % of Medicare · 49423 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 49423 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 49423 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 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.

How Washington, DC area compares for 49423

Across 109 of 109 payment localities, the office rate for 49423 runs from $476.82 in Arkansas to $771.71 in San Benito County, CA. Washington, DC area pays $641.02. The RVUs are the same everywhere; the geographic indexes change the dollars.

49423 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$641.02
  2. Los Angeles, CA · California$640.48−$0.54
  3. Miami, FL · Florida$577.98−$63.04
  4. Chicago, IL · Illinois$559.18−$81.84
  5. Manhattan, NY · New York$636.07−$4.95
  6. Alaska · Alaska$603.04−$37.98
  7. Alabama · Alabama$485.04−$155.98

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

49423 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$476.82$57.07
ArizonaArizona$533.28$59.77
Bakersfield, CACalifornia$595.94$60.37
Chico, CACalifornia$595.45$59.89
El Centro, CACalifornia$595.48$59.91
Fresno, CACalifornia$595.45$59.89
Hanford, CACalifornia$595.45$59.89
Madera, CACalifornia$595.45$59.89

49423 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.

$476.82

$683.58

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

View every state and territory as a table
49423 office rate range by state
State / territoryOffice rate rangeLocalities
AK$603.041
AL$485.041
AR$476.821
AZ$533.281
CA$595.45–$771.7129
CO$580.631
CT$589.761
DC$641.021
DE$543.181
FL$530.28–$577.983
GA$496.83–$558.612
GU$615.241
HI$615.241
IA$504.011
ID$506.891
IL$509.24–$567.314
IN$510.441
KS$499.111
KY$493.861
LA$492.10–$520.872
MA$575.44–$647.162
MD$555.44–$641.023
ME$507.69–$543.002
MI$506.92–$535.732
MN$560.091
MO$480.77–$525.623
MS$479.011
MT$549.431
NC$514.241
ND$546.271
NE$507.881
NH$569.141
NJ$597.55–$632.262
NM$509.301
NV$549.051
NY$523.02–$650.935
OH$506.281
OK$495.111
OR$545.87–$603.972
PA$508.42–$571.692
PR$554.831
RI$566.161
SC$510.901
SD$545.901
TN$501.771
TX$504.36–$577.748
UT$519.101
VA$539.43–$641.022
VI$554.831
VT$541.841
WA$575.11–$663.582
WI$524.891
WV$486.681
WY$548.061

See 49423 in every payment locality

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.

How the rate is built · 49423

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.42

1.42 RVUs× 1.000 GPCI

Practice expense14.87

14.87 RVUs× 1.000 GPCI

Malpractice0.16

0.16 RVUs× 1.000 GPCI

Adjusted RVUs

16.4500

Conversion factor

$33.4009

Medicare rate

$549.44

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,803

Code
49423
Physician work
1.42
Practice expense
14.87
Malpractice
0.16

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 49423 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.42× 1.0541.4967
Practice expense14.87× 1.17817.5169
Malpractice0.16× 1.1130.1781
Total RVUs19.1916
Conversion factor× 33.4009

Office rate, Washington, DC area$641.02

Office: (1.42 × 1.054 + 14.87 × 1.178 + 0.16 × 1.113) × $33.4009 = $641.02

Facility: (1.42 × 1.054 + 0.24 × 1.178 + 0.16 × 1.113) × $33.4009 = $65.38

Open 49423 in the RVU calculator

Payment rules and modifiers for 49423

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

CMS payment indicators · 49423

Drain catheter exchange, fluoroscopic exchange

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)0Not paid without supporting documentation.
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

49423 without 51 · national office

$549.44

Drain catheter exchange, fluoroscopic exchange

49423-51 · Second procedure: 50%

$274.72

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 49423

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

Codes related to 49423
CodeHow it relatesOffice range, Washington, DC area
Used instead
49405Visceral drainage, percutaneous catheter placementImage-guided placement of a new drainage catheter for a visceral collection, rather than exchange of an existing catheter.$969.74
49406Catheter drainage, peritoneal or retroperitonealImage-guided placement for a peritoneal or retroperitoneal collection when no existing catheter is being exchanged.$968.95
49407Pelvic drainage, transvaginal or transrectalImage-guided placement for a transrectal or transvaginal drainage approach, rather than catheter exchange.$849.72
49424Cavity contrast study, existing abscess, cyst, or tractContrast evaluation through an existing drainage catheter when the catheter is assessed without being exchanged.$198.24

How 49423 has changed in Washington, DC area

49423 · Office / nonfacility

$641.02

Effective 2026-10-01

The base rate is $4.39 higher than on 2025-10-01, moving from $636.63 to $641.02 (0.7%).

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

    $636.63changed to$641.02

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.46 changed to 1.42
    • Practice expense RVU 15.06 changed to 14.87
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $677.37changed to$636.63

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 15.62 changed to 15.06

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $666.32changed to$677.37

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $729.08changed to$666.32

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 16.28 changed to 15.62
    • Malpractice RVU 0.17 changed to 0.16
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $780.64changed to$729.08

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 16.88 changed to 16.28
    • Malpractice RVU 0.12 changed to 0.17
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $794.03changed to$780.64

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 17.03 changed to 16.88
    • Malpractice RVU 0.13 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $739.41changed to$794.03

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 15.40 changed to 17.03
    • Malpractice RVU 0.12 changed to 0.13
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $692.76changed to$739.41

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 14.55 changed to 15.40
    • Malpractice RVU 0.13 changed to 0.12
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $665.97changed to$692.76

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 13.95 changed to 14.55

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $662.83changed to$665.97

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 13.92 changed to 13.95
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $667.07changed to$662.83

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 14.05 changed to 13.92
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $668.67changed to$667.07

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 14.01 changed to 14.05
    • Malpractice RVU 0.15 changed to 0.13

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $665.34changed to$668.67

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $659.48changed to$665.34

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 13.93 changed to 14.01
    • Malpractice RVU 0.11 changed to 0.15
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $674.64changed to$659.48

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 15.16 changed to 13.93
    • Malpractice RVU 0.12 changed to 0.11
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $674.64

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$641.02$65.38RVU26D
2026-07-01$641.02$65.38RVU26C
2026-04-01$641.02$65.38RVU26B
2026-01-01$641.02$65.38RVU26A
2025-10-01$636.63$73.31RVU25D
2025-07-01$636.63$73.31RVU25C
2025-04-01$636.63$73.31RVU25B
2025-01-01$636.63$73.31RVU25A
2024-10-01$677.37$75.05RVU24D
2024-07-01$677.37$75.05RVU24C
2024-04-01$677.37$75.05RVU24B
2024-03-09$677.37$75.05RVU24AR
2024-01-01$666.32$73.82RVU24A
2023-10-01$729.08$77.85RVU23D
2023-07-01$729.08$77.85RVU23C
2023-04-01$729.08$77.85RVU23B
2023-01-01$729.08$77.85RVU23A
2022-10-01$780.64$77.88RVU22D
2022-07-01$780.64$77.88RVU22C
2022-04-01$780.64$77.88RVU22B
2022-01-01$780.64$77.88RVU22A
2021-10-01$794.03$79.40RVU21D
2021-07-01$794.03$79.40RVU21C
2021-04-01$794.03$79.40RVU21B
2021-01-01$794.03$79.40RVU21A
2020-10-01$739.41$81.51RVU20D
2020-07-01$739.41$81.51RVU20C
2020-04-01$739.41$81.51RVU20B
2020-01-01$739.41$81.51RVU20A
2019-10-01$692.76$81.74RVU19D
2019-07-01$692.76$81.74RVU19C
2019-04-01$692.76$81.74RVU19B
2019-01-01$692.76$81.74RVU19A
2018-10-01$665.97$81.65RVU18D
2018-07-01$665.97$81.65RVU18C
2018-04-01$665.97$81.65RVU18B
2018-01-01$665.97$81.65RVU18AR1
2017-10-01$662.83$82.03RVU17D
2017-07-01$662.83$82.03RVU17C
2017-04-01$662.83$82.03RVU17B
2017-01-01$662.83$82.03RVU17A
2016-10-01$667.07$82.47RVU16D
2016-07-01$667.07$82.47RVU16C
2016-04-01$667.07$82.47RVU16B
2016-01-01$667.07$82.47RVU16A
2015-10-01$668.67$83.69RVU15D
2015-07-01$668.67$83.69RVU15C
2015-04-01$665.34$83.27RVU15B
2015-01-01$665.34$83.27RVU15A
2014-10-01$659.48$82.06RVU14D
2014-07-01$659.48$82.06RVU14C
2014-04-01$659.48$82.06RVU14B
2014-01-01$659.48$82.06RVU14A
2013-10-01$674.64$78.73RVU13D
2013-07-01$674.64$78.73RVU13C
2013-04-01$674.64$78.73RVU13B
2013-01-01$674.64$78.73RVU13AR

Price 49423 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

49423 billing questions

When should this code be chosen instead of 49405, 49406, or 49407?

Use 49423 for exchanging a catheter already draining a collection. Codes 49405, 49406, and 49407 describe image-guided placement of a drainage catheter, with the applicable code determined by the collection site.

Is the fluoroscopic contrast assessment separately reported?

Fluoroscopic guidance, contrast injection, and radiological supervision and interpretation are included in the exchange service.

Can modifier 50 be used for an exchange on both sides?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

How does Medicare handle this service when other procedures occur in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

What documentation supports reporting the exchange?

Document the collection and existing catheter, the reason it needed replacement, the catheter exchange performed, and the fluoroscopic and contrast assessment.

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 49423PPRRVU2026_Oct_nonQPP.csv, line 5,803 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 49423 pays in Washington, DC area?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 49423 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist