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CPT code 49424: Cavity contrast study, existing abscess, cyst, or tract2026 Medicare rate & RVUs in Washington, DC area

Reports contrast injection and imaging to assess an existing abscess, cyst, or sinus tract, such as when evaluating a cavity reached through a drain.

CMS RVU26DEffective Oct 1, 2026One payment locality13.9K Medicare services in 2024

In Washington, DC area, Medicare pays $198.24 for 49424 in the office and $34.56 when it’s performed in a hospital or facility.

$198.24Office (non-facility)
$34.56Hospital or facility
+15.9%vs the national office rate ($171.01)

Check a contract rate as a % of Medicare · 49424 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 49424 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 49424 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 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.

How Washington, DC area compares for 49424

Across 109 of 109 payment localities, the office rate for 49424 runs from $149.58 in Arkansas to $236.28 in San Benito County, CA. Washington, DC area pays $198.24. The RVUs are the same everywhere; the geographic indexes change the dollars.

49424 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$198.24
  2. Los Angeles, CA · California$197.58−$0.66
  3. Miami, FL · Florida$180.49−$17.75
  4. Chicago, IL · Illinois$174.93−$23.31
  5. Manhattan, NY · New York$197.29−$0.95
  6. Alaska · Alaska$191.68−$6.56
  7. Alabama · Alabama$152.00−$46.24

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

Every other payment area

49424 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$149.58$30.22
ArizonaArizona$166.21$31.57
Bakersfield, CACalifornia$184.39$32.10
Chico, CACalifornia$184.17$31.88
El Centro, CACalifornia$184.18$31.89
Fresno, CACalifornia$184.17$31.88
Hanford, CACalifornia$184.17$31.88
Madera, CACalifornia$184.17$31.88

49424 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.

$149.58

$210.23

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

View every state and territory as a table
49424 office rate range by state
State / territoryOffice rate rangeLocalities
AK$191.681
AL$152.001
AR$149.581
AZ$166.211
CA$184.17–$236.2829
CO$180.011
CT$183.081
DC$198.241
DE$169.171
FL$165.85–$180.493
GA$155.91–$173.862
GU$189.751
HI$189.751
IA$157.371
ID$158.261
IL$159.80–$176.884
IN$159.301
KS$156.031
KY$154.831
LA$154.36–$162.842
MA$178.56–$199.702
MD$172.80–$198.243
ME$158.61–$168.852
MI$158.79–$167.582
MN$173.541
MO$151.09–$164.113
MS$150.391
MT$171.011
NC$160.521
ND$169.621
NE$158.471
NH$176.621
NJ$185.47–$195.762
NM$159.531
NV$170.771
NY$163.12–$201.815
OH$158.511
OK$155.091
OR$169.74–$186.792
PA$159.08–$177.812
PR$172.561
RI$175.981
SC$159.721
SD$169.461
TN$156.831
TX$157.89–$179.158
UT$162.141
VA$167.88–$198.242
VI$172.561
VT$168.421
WA$178.40–$204.502
WI$163.351
WV$153.161
WY$170.401

See 49424 in every payment locality

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

Office or facility?

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.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,804

Code
49424
Physician work
0.74
Practice expense
4.31
Malpractice
0.07

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 49424 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.74× 1.0540.7800
Practice expense4.31× 1.1785.0772
Malpractice0.07× 1.1130.0779
Total RVUs5.9350
Conversion factor× 33.4009

Office rate, Washington, DC area$198.24

Office: (0.74 × 1.054 + 4.31 × 1.178 + 0.07 × 1.113) × $33.4009 = $198.24

Facility: (0.74 × 1.054 + 0.15 × 1.178 + 0.07 × 1.113) × $33.4009 = $34.56

Open 49424 in the RVU calculator

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

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

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%).

When to use modifier 51

Codes related to 49424

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

Codes related to 49424
CodeHow it relatesOffice range, Washington, DC area
Used instead
49405Visceral drainage, percutaneous catheter placementDescribes image-guided drainage catheter placement for a visceral collection rather than assessment of an existing cavity.$969.74
49406Catheter drainage, peritoneal or retroperitonealDescribes image-guided drainage catheter placement for a peritoneal or retroperitoneal collection.$968.95
49407Pelvic drainage, transvaginal or transrectalDescribes image-guided drainage catheter placement for a transvaginal or transrectal collection.$849.72
49423Drain catheter exchange, fluoroscopic exchangeDescribes exchange of a drainage catheter, rather than contrast assessment of the cavity or tract.$641.02
49427Shunt injection, peritoneovenous shunt assessmentAssesses an abdominal-venous shunt by injection; 49424 evaluates a cavity or sinus tract.No office rate

How 49424 has changed in Washington, DC area

49424 · Office / nonfacility

$198.24

Effective 2026-10-01

The base rate is $1.12 higher than on 2025-10-01, moving from $197.12 to $198.24 (0.6%).

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

    $197.12changed to$198.24

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.76 changed to 0.74
    • Practice expense RVU 4.37 changed to 4.31
    • 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

    $208.80changed to$197.12

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.51 changed to 4.37
    • Malpractice RVU 0.08 changed to 0.07

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $205.39changed to$208.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $223.06changed to$205.39

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.68 changed to 4.51
    • 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

    $237.47changed to$223.06

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.82 changed to 4.68
    • 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

    $231.64changed to$237.47

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.66 changed to 4.82
    • Malpractice RVU 0.06 changed to 0.08

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $206.52changed to$231.64

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.95 changed to 4.66
    • Malpractice RVU 0.08 changed to 0.06
    • 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

    $184.67changed to$206.52

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.52 changed to 3.95
    • Malpractice RVU 0.07 changed to 0.08
    • 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

    $175.79changed to$184.67

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.32 changed to 3.52

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $174.92changed to$175.79

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.31 changed to 3.32
    • 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

    $175.91changed to$174.92

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.34 changed to 3.31
    • 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

    $176.11changed to$175.91

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.33 changed to 3.34

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $175.23changed to$176.11

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $174.13changed to$175.23

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.31 changed to 3.33
    • 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

    $176.14changed to$174.13

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.59 changed to 3.31
    • 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: $176.14

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$198.24$34.56RVU26D
2026-07-01$198.24$34.56RVU26C
2026-04-01$198.24$34.56RVU26B
2026-01-01$198.24$34.56RVU26A
2025-10-01$197.12$38.65RVU25D
2025-07-01$197.12$38.65RVU25C
2025-04-01$197.12$38.65RVU25B
2025-01-01$197.12$38.65RVU25A
2024-10-01$208.80$39.77RVU24D
2024-07-01$208.80$39.77RVU24C
2024-04-01$208.80$39.77RVU24B
2024-03-09$208.80$39.77RVU24AR
2024-01-01$205.39$39.12RVU24A
2023-10-01$223.06$41.23RVU23D
2023-07-01$223.06$41.23RVU23C
2023-04-01$223.06$41.23RVU23B
2023-01-01$223.06$41.23RVU23A
2022-10-01$237.47$42.42RVU22D
2022-07-01$237.47$42.42RVU22C
2022-04-01$237.47$42.42RVU22B
2022-01-01$237.47$42.42RVU22A
2021-10-01$231.64$41.87RVU21D
2021-07-01$231.64$41.87RVU21C
2021-04-01$231.64$41.87RVU21B
2021-01-01$231.64$41.87RVU21A
2020-10-01$206.52$44.36RVU20D
2020-07-01$206.52$44.36RVU20C
2020-04-01$206.52$44.36RVU20B
2020-01-01$206.52$44.36RVU20A
2019-10-01$184.67$43.53RVU19D
2019-07-01$184.67$43.53RVU19C
2019-04-01$184.67$43.53RVU19B
2019-01-01$184.67$43.53RVU19A
2018-10-01$175.79$43.48RVU18D
2018-07-01$175.79$43.48RVU18C
2018-04-01$175.79$43.48RVU18B
2018-01-01$175.79$43.48RVU18AR1
2017-10-01$174.92$43.89RVU17D
2017-07-01$174.92$43.89RVU17C
2017-04-01$174.92$43.89RVU17B
2017-01-01$174.92$43.89RVU17A
2016-10-01$175.91$43.89RVU16D
2016-07-01$175.91$43.89RVU16C
2016-04-01$175.91$43.89RVU16B
2016-01-01$175.91$43.89RVU16A
2015-10-01$176.11$44.05RVU15D
2015-07-01$176.11$44.05RVU15C
2015-04-01$175.23$43.83RVU15B
2015-01-01$175.23$43.83RVU15A
2014-10-01$174.13$44.10RVU14D
2014-07-01$174.13$44.10RVU14C
2014-04-01$174.13$44.10RVU14B
2014-01-01$174.13$44.10RVU14A
2013-10-01$176.14$42.04RVU13D
2013-07-01$176.14$42.04RVU13C
2013-04-01$176.14$42.04RVU13B
2013-01-01$176.14$42.04RVU13AR

Price 49424 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

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

Show the CMS file lines behind this rate
RVUs for 49424PPRRVU2026_Oct_nonQPP.csv, line 5,804 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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