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Billing code 49020: Abscess drainageMedicare rate & RVUs

Reports open surgical drainage of a peritoneal abscess or localized peritonitis, excluding an abscess arising from the appendix.

CMS RVU26DEffective Oct 1, 2026109 payment localities3.2K Medicare services in 2024

Medicare pays $1,488.01 for 49020 nationally in a facility.

Medicare rate · 49020

Abscess drainage

Swap in your local Medicare rate.

Work RVUs
26
Total RVUs
44.55
Global days
090

National rate · 2026

$1,488.01

Facility setting, before claim adjustments.

See every locality for 49020 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 49020 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 49020 covers

The surgeon opens the abdomen to reach and drain a peritoneal abscess or area of localized peritonitis. The service may involve evacuating infected material, irrigating the cavity, and placing a drain as clinically indicated. General surgeons commonly perform it in a hospital operating room for a localized intra-abdominal infection requiring open treatment; it is not the code for an appendiceal abscess or a retroperitoneal collection.

Choose the code based on the documented infection site and open approach. The operative report should identify the abscess or localized peritonitis and describe its drainage. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. An assistant at surgery may be paid; co-surgeon and team-surgery billing 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 49020 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

49020 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,345.13
Alaska*Unavailable$1,853.65
ArizonaUnavailable$1,444.87
ArkansasUnavailable$1,327.80
AtlantaUnavailable$1,539.70
AustinUnavailable$1,489.26
BakersfieldUnavailable$1,460.86
Baltimore/Surr. CntysUnavailable$1,581.86
BeaumontUnavailable$1,436.27
BrazoriaUnavailable$1,444.70

49020 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
49020 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 49020 rate is calculated

Each of 49020’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 · 49020

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 26.00Practice expense 12.21Malpractice 6.34

44.5500 adjusted RVUs×$33.4009 conversion factor=$1,488.01

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 49020

49020 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 49020

Abscess drainage

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 49020

Abscess drainage

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49020 without 51 · national facility

$1,488.01

Abscess drainage

49020-51 · Second procedure: 50%

$744.01

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

49020 compared with similar codes

Compare codes

49020 vs 49000 vs 49040 vs 49060 vs 49083: national Medicare rates

Swap in your local Medicare rate.

  • 49020
    Abscess drainage · 26 wRVU
    —
  • 49000
    Abdominal exploration · 12.23 wRVU
    —
  • 49040
    Abscess drainage · 16.11 wRVU
    —
  • 49060
    Abscess drainage · 18.07 wRVU
    —
  • 49083
    Paracentesis · 1.95 wRVU
    $284.24

How to choose

49000Abdominal exploration
49000 describes abdominal exploration. When exploration is performed to reach and drain the abscess, it is part of the operative service rather than a separate report with 49020.
49040Abscess drainage
Choose 49040 for an open-drained subphrenic or subdiaphragmatic abscess; 49020 covers a peritoneal abscess or localized peritonitis.
49060Abscess drainage
Choose 49060 when the abscess is retroperitoneal. A peritoneal abscess or localized peritonitis treated through an open approach is described by 49020.
49083Paracentesis
49083 is image-guided paracentesis for abdominal fluid, not open surgical drainage of a localized peritoneal abscess.

Codes related to 49020

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

Codes related to 49020
CodeHow it relatesNational office range
Used instead
49040Abscess drainageOpen drainage for a subphrenic or subdiaphragmatic abscess.No office rate
49060Abscess drainageOpen drainage when the abscess is retroperitoneal.No office rate
49084Peritoneal lavagePeritoneal lavage addresses a lavage service rather than open drainage of a localized abscess.No office rate

49020 billing questions

How does this differ from open drainage of a subphrenic abscess?

Use 49020 for a peritoneal abscess or localized peritonitis. A subphrenic or subdiaphragmatic abscess is reported with 49040.

Can 49020 be used for an appendiceal abscess?

No. The service described by 49020 excludes appendiceal abscess; select the applicable appendiceal procedure based on the operation performed.

Is abdominal exploration separately reported with the drainage?

Exploration performed to locate and reach the abscess is part of the open drainage service. Do not separately report 49000 for that operative access.

Should modifier 50 be appended for bilateral findings?

No. Modifier 50 is inappropriate for this service, and CMS makes no bilateral payment adjustment.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted under the CMS rules for this code.

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 49020PPRRVU2026_Oct_nonQPP.csv, line 5,766 (RVU26D)

Open CMS sourceHow we calculate rates

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