CPT code 49424: Cavity contrast study, existing abscess, cyst, or tract2026 Medicare rate & RVUs in California
Reports contrast injection and imaging to assess an existing abscess, cyst, or sinus tract, such as when evaluating a cavity reached through a drain.
Medicare pays $184.17–$236.28 for 49424 in the office in California, from Chico, CA to San Benito County, CA. 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 49424 covers
A clinician injects contrast through an existing catheter or other access into an abscess cavity, cyst, or sinus tract, then obtains and interprets imaging to assess its shape, extent, or communication with nearby structures. This study is commonly performed by an interventional radiologist or another physician managing a percutaneous drain, in a hospital or outpatient setting. A sinogram through an established tract is a typical use; this code describes assessment, not placement of a new drainage catheter.
Report the study when documentation identifies the target cavity or tract, the reason for assessment, the contrast injection and imaging performed, and the findings. The service includes radiological supervision and interpretation. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. 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 49424 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$184.17 to $236.28
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $184.39 | $32.10 |
| Chico, CA | $184.17 | $31.88 |
| El Centro, CA | $184.18 | $31.89 |
| Fresno, CA | $184.17 | $31.88 |
| Hanford, CA | $184.17 | $31.88 |
| Los Angeles, CA | $197.58 | $33.21 |
| Madera, CA | $184.17 | $31.88 |
| Marin County, CA | $231.12 | $35.20 |
| Merced, CA | $184.17 | $31.88 |
| Modesto, CA | $184.17 | $31.88 |
| Napa, CA | $217.20 | $34.06 |
| Oxnard, CA | $197.02 | $32.79 |
| Redding, CA | $184.17 | $31.88 |
| Rest of California | $184.17 | $31.88 |
| Riverside, CA | $184.93 | $32.65 |
| Sacramento, CA | $194.28 | $32.69 |
| Salinas, CA | $193.58 | $32.54 |
| San Benito County, CA | $236.28 | $35.91 |
| San Diego, CA | $198.90 | $32.72 |
| San Francisco, CA | $231.04 | $35.12 |
| San Luis Obispo, CA | $190.36 | $32.10 |
| Santa Clara County, CA | $235.95 | $35.59 |
| Santa Cruz, CA | $201.40 | $32.58 |
| Santa Maria, CA | $194.52 | $32.50 |
| Santa Rosa, CA | $203.49 | $32.86 |
| Stockton, CA | $184.17 | $31.88 |
| Vallejo, CA | $217.08 | $33.95 |
| Visalia, CA | $184.17 | $31.88 |
| Yuba City, CA | $184.17 | $31.88 |
How the 49424 rate is calculated
Each of 49424’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 · 49424
RVUs × geographic indexes × conversion factor
Work0.74
0.74 RVUs× 1.000 GPCI
Practice expense4.31
4.31 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
5.1200
Conversion factor
$33.4009
Medicare rate
$171.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49424
The CMS indicators that decide how 49424 is paid alongside other services.
CMS payment indicators · 49424
Cavity contrast study, existing abscess, cyst, or tract
| 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) | 0 | Not paid without supporting documentation. |
| 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
49424 without 51 · national office
$171.01
Cavity contrast study, existing abscess, cyst, or tract
49424-51 · Second procedure: 50%
$85.51
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%).
49424 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 49405Visceral drainagePercutaneous catheter placement
- Choose 49405 when placing a catheter to drain a visceral collection. Choose 49424 when injecting contrast to assess an existing cavity or tract.
- 49423Drain catheter exchangeFluoroscopic exchange
- 49423 describes exchanging a drainage catheter. 49424 describes a contrast study of an abscess, cyst, or sinus tract.
- 49427Shunt injectionPeritoneovenous shunt assessment
- 49427 concerns injection assessment of an abdominal-venous shunt; 49424 assesses an abscess cavity, cyst, or sinus tract.
49424 billing questions
When should I report this instead of a drainage-catheter placement code?
Report 49424 for contrast assessment of an existing cavity or tract. Codes 49405–49407 describe image-guided catheter placement to drain collections at specified sites.
Does this code include the imaging interpretation?
Yes. The service includes radiological supervision and interpretation along with the contrast injection.
Can I append modifier 50 for a study involving both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
What documentation supports reporting 49424?
Document the cavity or tract assessed, the clinical reason, the contrast injection and imaging, and the interpretation. The record should make clear that the study assessed an existing access or tract rather than placing a new drain.
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
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