Billing code 49405: Visceral drainageMedicare rate & RVUs
Reports image-guided percutaneous catheter drainage of a collection within a visceral organ, such as an abscess or cyst, in the peritoneal or retroperitoneal region.
Medicare pays $837.69 for 49405 nationally in the office and $166.67 in a hospital or facility. Local office rates run $733.12–$1,152.00.
Medicare rate · 49405
Visceral drainage
Swap in your local Medicare rate.
- Work RVUs
- 3.9
- Total RVUs
- 25.08
- Global days
- 000
National rate · 2026
$837.69
Office setting, before claim adjustments.
See every locality for 49405 → · 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
What 49405 covers
A physician, commonly an interventional radiologist, uses imaging to guide a catheter through the skin into a fluid collection within a visceral organ and establish drainage. A typical example is catheter drainage of a liver abscess. The procedure is generally performed in a hospital or other imaging suite, with the catheter left in place to drain the collection as clinically indicated.
Select this service when the collection is within a visceral structure; a collection located in the peritoneal or retroperitoneal space is distinguished by the target anatomy. Document the collection’s location, the percutaneous approach, image guidance, and catheter placement. Imaging guidance is included in the drainage service. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and 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 49405 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$733.12 to $1152.00
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $744.93 | $157.78 |
| Alaska* | $941.60 | $226.96 |
| Arizona | $814.18 | $163.96 |
| Arkansas | $733.12 | $156.71 |
| Atlanta | $852.00 | $170.24 |
| Austin | $876.57 | $166.63 |
| Bakersfield | $901.25 | $165.81 |
| Baltimore/Surr. Cntys | $893.72 | $173.71 |
| Beaumont | $774.29 | $163.66 |
| Brazoria | $829.41 | $164.42 |
| Chicago | $860.24 | $185.86 |
| Chico | $899.97 | $164.52 |
| Colorado | $880.56 | $166.59 |
| Connecticut | $896.64 | $173.94 |
| Dallas | $834.10 | $165.76 |
| Dc + Md/Va Suburbs | $969.74 | $179.27 |
| Delaware | $828.61 | $165.64 |
| Detroit | $823.05 | $175.51 |
| East St. Louis | $796.45 | $179.10 |
| El Centro | $900.04 | $164.59 |
| Fort Lauderdale | $858.04 | $178.30 |
| Fort Worth | $827.35 | $165.72 |
| Fresno | $899.97 | $164.52 |
| Galveston | $831.47 | $165.14 |
| Hanford-Corcoran | $899.97 | $164.52 |
| Hawaii, Guam | $926.78 | $163.83 |
| Houston | $839.16 | $172.83 |
| Idaho | $774.83 | $157.49 |
| Indiana | $779.87 | $157.83 |
| Iowa | $770.30 | $156.31 |
| Kansas | $764.17 | $157.56 |
| Kentucky | $759.53 | $162.99 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $965.21 | $171.39 |
| Madera | $899.97 | $164.52 |
| Manhattan | $966.58 | $186.85 |
| Merced | $899.97 | $164.52 |
| Metropolitan Boston | $976.01 | $174.81 |
| Metropolitan Kansas City | $795.07 | $164.98 |
| Metropolitan Philadelphia | $871.18 | $172.64 |
| Metropolitan St. Louis | $804.44 | $165.62 |
| Miami | $887.57 | $189.04 |
| Minnesota | $847.93 | $157.44 |
| Mississippi | $737.65 | $159.90 |
| Modesto | $899.97 | $164.52 |
| Montana** | $837.67 | $166.64 |
| Napa | $1,059.50 | $175.09 |
| Nebraska | $775.58 | $156.22 |
| Nevada** | $836.05 | $164.35 |
| New Hampshire | $864.37 | $165.83 |
| New Mexico | $782.96 | $167.63 |
| New Orleans | $798.69 | $167.26 |
| North Carolina | $786.17 | $160.11 |
| North Dakota** | $829.36 | $158.34 |
| Northern Nj | $957.80 | $179.41 |
| Nyc Suburbs/Long Island | $989.11 | $191.26 |
| Ohio | $777.48 | $164.84 |
| Oklahoma | $760.37 | $161.15 |
| Oxnard-Thousand Oaks-Ventura | $962.25 | $169.10 |
| Portland | $913.16 | $167.65 |
| Poughkpsie/N Nyc Suburbs | $912.38 | $177.60 |
| Puerto Rico | $845.11 | $166.71 |
| Queens | $978.43 | $185.28 |
| Redding | $899.97 | $164.52 |
| Rest Of California | $899.97 | $164.52 |
| Rest Of Florida | $814.24 | $172.74 |
| Rest Of Georgia | $765.50 | $166.95 |
| Rest Of Illinois | $785.27 | $172.62 |
| Rest Of Louisiana | $757.36 | $163.51 |
| Rest Of Maine | $776.92 | $159.58 |
| Rest Of Maryland | $846.17 | $167.09 |
| Rest Of Massachusetts | $873.68 | $167.09 |
| Rest Of Michigan | $779.18 | $166.53 |
| Rest Of Missouri | $741.64 | $163.22 |
| Rest Of New Jersey | $908.06 | $175.30 |
| Rest Of New York | $798.86 | $161.39 |
| Rest Of Oregon | $830.75 | $162.41 |
| Rest Of Pennsylvania | $780.06 | $164.06 |
| Rest Of Texas | $800.97 | $164.17 |
| Rest Of Washington | $872.79 | $166.20 |
| Rhode Island | $861.54 | $168.37 |
| Riverside-San Bernardino-Ontario | $904.54 | $169.10 |
| Sacramento-Roseville-Folsom | $948.90 | $168.50 |
| Salinas | $945.47 | $167.76 |
| San Diego-Chula Vista-Carlsbad | $971.08 | $168.54 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $1,126.78 | $180.63 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $1,126.30 | $180.15 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $1,152.00 | $184.38 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $1,150.05 | $182.43 |
| San Luis Obispo-Paso Robles | $929.78 | $165.49 |
| Santa Cruz-Watsonville | $983.00 | $167.71 |
| Santa Maria-Santa Barbara | $949.94 | $167.52 |
| Santa Rosa-Petaluma | $993.19 | $169.17 |
| Seattle (King Cnty) | $999.04 | $175.70 |
| South Carolina | $782.89 | $162.87 |
| South Dakota** | $828.38 | $157.36 |
| Southern Maine | $826.28 | $161.29 |
| Stockton | $899.97 | $164.52 |
| Suburban Chicago | $868.16 | $179.02 |
| Tennessee | $768.10 | $158.14 |
| Utah | $794.66 | $163.90 |
| Vallejo | $1,058.81 | $174.40 |
| Vermont | $823.83 | $159.52 |
| Virgin Islands | $845.11 | $166.71 |
| Virginia | $821.78 | $162.17 |
| Visalia | $899.97 | $164.52 |
| West Virginia | $752.91 | $169.79 |
| Wisconsin | $798.86 | $156.02 |
| Wyoming** | $834.05 | $163.02 |
| Yuba City | $899.97 | $164.52 |
49405 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$733.12
$1,025.99
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $941.60 | 1 |
| AL | $744.93 | 1 |
| AR | $733.12 | 1 |
| AZ | $814.18 | 1 |
| CA | $899.97–$1,152.00 | 29 |
| CO | $880.56 | 1 |
| CT | $896.64 | 1 |
| DC | $969.74 | 1 |
| DE | $828.61 | 1 |
| FL | $814.24–$887.57 | 3 |
| GA | $765.50–$852.00 | 2 |
| GU | $926.78 | 1 |
| HI | $926.78 | 1 |
| IA | $770.30 | 1 |
| ID | $774.83 | 1 |
| IL | $785.27–$868.16 | 4 |
| IN | $779.87 | 1 |
| KS | $764.17 | 1 |
| KY | $759.53 | 1 |
| LA | $757.36–$798.69 | 2 |
| MA | $873.68–$976.01 | 2 |
| MD | $846.17–$969.74 | 3 |
| ME | $776.92–$826.28 | 2 |
| MI | $779.18–$823.05 | 2 |
| MN | $847.93 | 1 |
| MO | $741.64–$804.44 | 3 |
| MS | $737.65 | 1 |
| MT | $837.67 | 1 |
| NC | $786.17 | 1 |
| ND | $829.36 | 1 |
| NE | $775.58 | 1 |
| NH | $864.37 | 1 |
| NJ | $908.06–$957.80 | 2 |
| NM | $782.96 | 1 |
| NV | $836.05 | 1 |
| NY | $798.86–$989.11 | 5 |
| OH | $777.48 | 1 |
| OK | $760.37 | 1 |
| OR | $830.75–$913.16 | 2 |
| PA | $780.06–$871.18 | 2 |
| PR | $845.11 | 1 |
| RI | $861.54 | 1 |
| SC | $782.89 | 1 |
| SD | $828.38 | 1 |
| TN | $768.10 | 1 |
| TX | $774.29–$876.57 | 8 |
| UT | $794.66 | 1 |
| VA | $821.78–$969.74 | 2 |
| VI | $845.11 | 1 |
| VT | $823.83 | 1 |
| WA | $872.79–$999.04 | 2 |
| WI | $798.86 | 1 |
| WV | $752.91 | 1 |
| WY | $834.05 | 1 |
How the 49405 rate is calculated
Each of 49405’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 · 49405
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.90Practice expense 20.76Malpractice 0.42
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49405
The CMS indicators that decide how 49405 is paid alongside other services.
CMS payment indicators · 49405
Visceral drainage
| 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) | 1 | Not paid (statutory restriction). |
| 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
49405 without 51 · national office
$837.69
Visceral drainage
49405-51 · Second procedure: 50%
$418.85
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%).
49405 compared with similar codes
Compare codes
49405 vs 49406 vs 49407 vs 49423: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 49406Catheter drainage
- Choose 49405 when the collection is within a visceral organ. Choose 49406 when the target is a collection in the peritoneal or retroperitoneal space.
- 49407Pelvic drainage
- 49407 describes collection drainage through a transvaginal or transrectal route. This code describes percutaneous catheter drainage of a visceral collection.
- 49423Drain catheter exchange
- 49423 is for exchanging a drainage catheter already in place. This code is for image-guided percutaneous catheter drainage of a visceral collection.
49405 billing questions
How is this code distinguished from 49406?
Use 49405 for a collection within a visceral organ. Code 49406 is for a peritoneal or retroperitoneal collection rather than a collection within a visceral structure.
Is imaging guidance separately reported?
No. Imaging guidance is included in this drainage service.
What documentation supports code selection?
Document the collection’s anatomic location, percutaneous access, use of imaging guidance, and catheter placement. The record should make clear that the target is within a visceral organ.
Does the service have a global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for this code.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction.
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
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