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Billing code 49040: Abscess drainageMedicare rate & RVUs

Reports open surgical drainage of an abdominal abscess when the surgeon treats the collection through an operative approach rather than percutaneous catheter drainage.

CMS RVU26DEffective Oct 1, 2026109 payment localities93 Medicare services in 2024

Medicare pays $958.94 for 49040 nationally in a facility.

Medicare rate · 49040

Abscess drainage

Work RVUs
16.11
Total RVUs
28.71
Global days
090

National rate · 2026

$958.94

Facility setting, before claim adjustments.

See every locality for 49040 →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 49040 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 49040 covers

billing code 49040 reports operative access to and evacuation of a localized abdominal abscess through an open approach. A surgeon typically performs the procedure in a hospital operating room when the collection requires surgical exposure. The operative report should identify the abscess location and document that drainage was performed through an open approach.

Choose the code based on the documented site and method; compare 49020 for a peritoneal abscess and 49060 for a retroperitoneal abscess. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and related postoperative care through day 90. For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. Modifier 50 is inappropriate, and team surgery is 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 49040 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

49040 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$863.50
Alaska*Unavailable$1,184.09
ArizonaUnavailable$930.23
ArkansasUnavailable$851.92
AtlantaUnavailable$992.93
AustinUnavailable$960.58
BakersfieldUnavailable$942.06
Baltimore/Surr. CntysUnavailable$1,021.00
BeaumontUnavailable$923.70
BrazoriaUnavailable$930.21

49040 rates by state

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

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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.

View every state and territory as a table
49040 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 49040 rate is calculated

Each of 49040’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 · 49040

RVUs × geographic indexes × conversion factor

Work16.11

16.11 RVUs× 1.000 GPCI

Practice expense8.45

8.45 RVUs× 1.000 GPCI

Malpractice4.15

4.15 RVUs× 1.000 GPCI

Adjusted RVUs

28.7100

Conversion factor

$33.4009

Medicare rate

$958.94

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

Payment rules and modifiers for 49040

49040 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 49040

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)1Permitted with supporting documentation.
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 · 49040

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

49040 without 51 · national facility

$958.94

Abscess drainage

49040-51 · Second procedure: 50%

$479.47

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

49040 compared with similar codes

Compare codes · National

4 codes, side by side

  • 49040

    Abscess drainage16.11 wRVU

    Not priced

  • 49020

    Abscess drainage26 wRVU

    Not priced

  • 49060

    Abscess drainage18.07 wRVU

    Not priced

  • 49062

    Peritoneal drainage11.91 wRVU

    Not priced

How to choose

49020Abscess drainage
49020 is the comparison for a peritoneal abscess or localized peritonitis; 49040 applies when the documented abdominal abscess and open procedure fit 49040.
49060Abscess drainage
Choose 49060 when the abscess is retroperitoneal. For 49040, the documentation must support the abdominal abscess service rather than the retroperitoneal site.
49062Peritoneal drainage
49040 describes open operative drainage. Consider 49062 only when the procedure is percutaneous and its site and service match that code.

Codes related to 49040

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

Codes related to 49040
CodeHow it relatesNational office range
Used instead
49020Abscess drainageCompare when the documented collection is a peritoneal abscess or localized peritonitis.No office rate
49060Abscess drainageUse as the site-specific comparison for an open retroperitoneal abscess drainage.No office rate
49062Peritoneal drainageCompare for a percutaneous drainage approach when the documented site and service meet that code.No office rate

49040 billing questions

How does 49040 differ from 49020?

Use 49040 for open drainage of an abdominal abscess when its documented site and circumstances fit that code. Compare 49020 when the operative documentation identifies a peritoneal abscess or localized peritonitis.

When should 49060 be considered instead?

49060 is the code to compare when the abscess is documented as retroperitoneal. The operative report should support the anatomic site.

Does percutaneous catheter drainage qualify for 49040?

No. 49040 describes an open operative approach; a percutaneous procedure requires a code that matches its method and documented site.

How does the 90-day global period affect billing?

The day-before preoperative visit and related postoperative care through day 90 are included in the major-surgery global period.

Can assistant or co-surgeon services be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

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 49040PPRRVU2026_Oct_nonQPP.csv, line 5,767 (RVU26D)

Open CMS sourceHow we calculate rates

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