$733.12–$1,152.00
49405 addresses drainage of a visceral collection. This code is selected for a pelvic collection accessed transvaginally or transrectally.
On this page
CMS RVU26D · Effective 2026-10-01
49407 Pelvic drainage Medicare reimbursement rates
Reports image-guided catheter drainage of a pelvic fluid collection through a transvaginal or transrectal route, such as drainage of a deep pelvic abscess. Compare 49407 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 49407?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$646.57–$1001.16
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $354.59 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 49407 pays more and less
109 payment localities
$646.57 to $1001.16
Image-guided drainage
About 49407: Image-guided transvaginal fluid drainage
Reports image-guided catheter drainage of a pelvic fluid collection through a transvaginal or transrectal route, such as drainage of a deep pelvic abscess.
This service places a drainage catheter into a pelvic fluid collection using a transvaginal or transrectal approach and image guidance. Interventional radiologists commonly perform it in a hospital or other facility for collections that can be accessed through the vagina or rectum, including selected postoperative pelvic abscesses. The catheter provides ongoing drainage; needle aspiration alone is not the defining service.
Choose this code when the documented access route is transvaginal or transrectal, rather than selecting a code for a visceral, peritoneal, or retroperitoneal collection. The report should identify the collection, its location, the access route, image guidance, and catheter placement. The code includes the image-guided drainage service. CMS assigns 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 the others are subject to the standard 50% reduction. CMS restricts assistant-at-surgery payment and does not permit co-surgeon or team-surgery billing for this service.
CMS billing rules for 49407
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.14 · 19%
- Practice expense (office) RVU17.41 · 79%
- Malpractice RVU0.51 · 2%
115
Medicare services in 2024 · #4772 by national volume
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.
49407 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$732.55–$1,151.04
49406 is for a peritoneal or retroperitoneal collection. Select this code when the documented access is transvaginal or transrectal.
No office rate
49020 describes open surgical drainage of a peritoneal abscess. This code describes image-guided catheter drainage through a transvaginal or transrectal route.
See how rates vary across the country
49407 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$646.57
$894.13
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $836.11 | 1 |
| AL | $656.74 | 1 |
| AR | $646.57 | 1 |
| AZ | $716.34 | 1 |
| CA | $787.10–$1,001.16 | 29 |
| CO | $771.97 | 1 |
| CT | $787.94 | 1 |
| DC | $849.72 | 1 |
| DE | $728.82 | 1 |
| FL | $719.81–$786.71 | 3 |
| GA | $677.29–$749.97 | 2 |
| GU | $809.32 | 1 |
| HI | $809.32 | 1 |
| IA | $677.12 | 1 |
| ID | $681.33 | 1 |
| IL | $695.82–$766.64 | 4 |
| IN | $685.62 | 1 |
| KS | $672.55 | 1 |
| KY | $670.83 | 1 |
| LA | $669.23–$704.83 | 2 |
| MA | $766.40–$853.43 | 2 |
| MD | $743.79–$849.72 | 3 |
| ME | $683.86–$725.30 | 2 |
| MI | $688.43–$728.16 | 2 |
| MN | $741.70 | 1 |
| MO | $656.13–$708.95 | 3 |
| MS | $651.55 | 1 |
| MT | $736.79 | 1 |
| NC | $691.71 | 1 |
| ND | $726.71 | 1 |
| NE | $681.45 | 1 |
| NH | $758.54 | 1 |
| NJ | $797.51–$839.74 | 2 |
| NM | $691.98 | 1 |
| NV | $734.56 | 1 |
| NY | $702.69–$870.18 | 5 |
| OH | $686.37 | 1 |
| OK | $670.80 | 1 |
| OR | $729.44–$799.22 | 2 |
| PA | $688.20–$766.44 | 2 |
| PR | $742.96 | 1 |
| RI | $756.80 | 1 |
| SC | $690.07 | 1 |
| SD | $725.51 | 1 |
| TN | $676.02 | 1 |
| TX | $683.28–$768.89 | 8 |
| UT | $700.20 | 1 |
| VA | $721.93–$849.72 | 2 |
| VI | $742.96 | 1 |
| VT | $722.59 | 1 |
| WA | $765.37–$872.62 | 2 |
| WI | $700.61 | 1 |
| WV | $667.99 | 1 |
| WY | $732.39 | 1 |
Compare 49407 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $656.74 | Facility $169.55 |
| Alaska* | Office $836.11 | Facility $243.13 |
| Arizona | Office $716.34 | Facility $176.81 |
| Arkansas | Office $646.57 | Facility $168.28 |
| Atlanta | Office $749.97 | Facility $184.27 |
| Austin | Office $768.89 | Facility $179.80 |
| Bakersfield | Office $788.62 | Facility $178.37 |
| Baltimore/Surr. Cntys | Office $785.52 | Facility $188.08 |
| Beaumont | Office $683.28 | Facility $176.60 |
| Brazoria | Office $728.95 | Facility $177.17 |
| Chicago | Office $762.76 | Facility $203.18 |
| Chico | Office $787.10 | Facility $176.85 |
| Colorado | Office $771.97 | Facility $179.54 |
| Connecticut | Office $787.94 | Facility $188.28 |
| Dallas | Office $733.32 | Facility $178.76 |
| Dc + Md/Va Suburbs | Office $849.72 | Facility $193.82 |
| Delaware | Office $728.82 | Facility $178.71 |
| Detroit | Office $728.16 | Facility $190.85 |
| East St. Louis | Office $707.58 | Facility $195.33 |
| El Centro | Office $787.18 | Facility $176.94 |
| Fort Lauderdale | Office $758.15 | Facility $194.12 |
| Fort Worth | Office $727.73 | Facility $178.73 |
| Fresno | Office $787.10 | Facility $176.85 |
| Galveston | Office $730.93 | Facility $178.03 |
| Hanford-Corcoran | Office $787.10 | Facility $176.85 |
| Hawaii, Guam | Office $809.32 | Facility $176.25 |
| Houston | Office $740.26 | Facility $187.37 |
| Idaho | Office $681.33 | Facility $169.08 |
| Indiana | Office $685.62 | Facility $169.47 |
| Iowa | Office $677.12 | Facility $167.66 |
| Kansas | Office $672.55 | Facility $169.21 |
| Kentucky | Office $670.83 | Facility $175.84 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $843.19 | Facility $184.50 |
| Madera | Office $787.10 | Facility $176.85 |
| Manhattan | Office $849.86 | Facility $202.87 |
| Merced | Office $787.10 | Facility $176.85 |
| Metropolitan Boston | Office $853.43 | Facility $188.62 |
| Metropolitan Kansas City | Office $700.96 | Facility $178.13 |
| Metropolitan Philadelphia | Office $766.44 | Facility $186.82 |
| Metropolitan St. Louis | Office $708.95 | Facility $178.88 |
| Miami | Office $786.71 | Facility $207.09 |
| Minnesota | Office $741.70 | Facility $168.76 |
| Mississippi | Office $651.55 | Facility $172.15 |
| Modesto | Office $787.10 | Facility $176.85 |
| Montana** | Office $736.79 | Facility $180.00 |
| Napa | Office $922.07 | Facility $188.22 |
| Nebraska | Office $681.45 | Facility $167.53 |
| Nevada** | Office $734.56 | Facility $177.21 |
| New Hampshire | Office $758.54 | Facility $178.91 |
| New Mexico | Office $691.98 | Facility $181.40 |
| New Orleans | Office $704.83 | Facility $180.89 |
| North Carolina | Office $691.71 | Facility $172.23 |
| North Dakota** | Office $726.71 | Facility $169.91 |
| Northern Nj | Office $839.74 | Facility $193.86 |
| Nyc Suburbs/Long Island | Office $870.18 | Facility $208.15 |
| Ohio | Office $686.37 | Facility $178.02 |
| Oklahoma | Office $670.80 | Facility $173.59 |
| Oxnard-Thousand Oaks-Ventura | Office $840.11 | Facility $181.98 |
| Portland | Office $799.22 | Facility $180.63 |
| Poughkpsie/N Nyc Suburbs | Office $801.87 | Facility $192.18 |
| Puerto Rico | Office $742.96 | Facility $180.05 |
| Queens | Office $859.04 | Facility $200.91 |
| Redding | Office $787.10 | Facility $176.85 |
| Rest Of California | Office $787.10 | Facility $176.85 |
| Rest Of Florida | Office $719.81 | Facility $187.51 |
| Rest Of Georgia | Office $677.29 | Facility $180.63 |
| Rest Of Illinois | Office $695.82 | Facility $187.47 |
| Rest Of Louisiana | Office $669.23 | Facility $176.47 |
| Rest Of Maine | Office $683.86 | Facility $171.61 |
| Rest Of Maryland | Office $743.79 | Facility $180.31 |
| Rest Of Massachusetts | Office $766.40 | Facility $180.10 |
| Rest Of Michigan | Office $688.43 | Facility $180.08 |
| Rest Of Missouri | Office $656.13 | Facility $176.18 |
| Rest Of New Jersey | Office $797.51 | Facility $189.49 |
| Rest Of New York | Office $702.69 | Facility $173.74 |
| Rest Of Oregon | Office $729.44 | Facility $174.87 |
| Rest Of Pennsylvania | Office $688.20 | Facility $177.07 |
| Rest Of Texas | Office $705.51 | Facility $177.12 |
| Rest Of Washington | Office $765.37 | Facility $179.07 |
| Rhode Island | Office $756.80 | Facility $181.63 |
| Riverside-San Bernardino-Ontario | Office $792.63 | Facility $182.39 |
| Sacramento-Roseville-Folsom | Office $828.68 | Facility $181.13 |
| Salinas | Office $825.67 | Facility $180.34 |
| San Diego-Chula Vista-Carlsbad | Office $847.15 | Facility $181.22 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $979.16 | Facility $194.09 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $978.58 | Facility $193.51 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $1001.16 | Facility $198.26 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $998.79 | Facility $195.89 |
| San Luis Obispo-Paso Robles | Office $812.10 | Facility $177.91 |
| Santa Cruz-Watsonville | Office $856.85 | Facility $180.34 |
| Santa Maria-Santa Barbara | Office $829.32 | Facility $180.10 |
| Santa Rosa-Petaluma | Office $865.65 | Facility $181.91 |
| Seattle (King Cnty) | Office $872.62 | Facility $189.44 |
| South Carolina | Office $690.07 | Facility $175.60 |
| South Dakota** | Office $725.51 | Facility $168.72 |
| Southern Maine | Office $725.30 | Facility $173.52 |
| Stockton | Office $787.10 | Facility $176.85 |
| Suburban Chicago | Office $766.64 | Facility $194.82 |
| Tennessee | Office $676.02 | Facility $169.89 |
| Utah | Office $700.20 | Facility $176.81 |
| Vallejo | Office $921.24 | Facility $187.39 |
| Vermont | Office $722.59 | Facility $171.37 |
| Virgin Islands | Office $742.96 | Facility $180.05 |
| Virginia | Office $721.93 | Facility $174.60 |
| Visalia | Office $787.10 | Facility $176.85 |
| West Virginia | Office $667.99 | Facility $184.13 |
| Wisconsin | Office $700.61 | Facility $167.20 |
| Wyoming** | Office $732.39 | Facility $175.60 |
| Yuba City | Office $787.10 | Facility $176.85 |
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49407 billing questions
When should this code be selected instead of 49406?
Use this code when the catheter reaches the pelvic collection through a transvaginal or transrectal route. Code 49406 is for image-guided drainage of a peritoneal or retroperitoneal collection.
Does the code include image guidance?
Yes. Image guidance is part of this catheter drainage service; documentation should identify the guidance used and the catheter placement.
Can modifier 50 be used for drainage on both sides?
Modifier 50 is inappropriate for this service. Report the procedure based on the documented collection and transvaginal or transrectal access.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the other procedures performed in that session.
Is same-day recovery care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant or co-surgeon be billed?
CMS restricts assistant-at-surgery payment for this service and does not permit co-surgeon or team-surgery billing.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,79349402,,Remove foreign body adbomen,A,,13.74,6.88,NA,6.88,,3.32,23.94,23.94,0,090,0.09,0.81,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,79449405,,Image cath fluid colxn visc,A,,3.90,20.76,,0.67,,0.42,25.08,4.99,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,79549406,,Image cath fluid peri/retro,A,,3.90,20.74,,0.67,,0.42,25.06,4.99,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,79649407,,Image cath fluid trns/vgnl,A,,4.14,17.41,,0.74,,0.51,22.06,5.39,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,79749411,,Ins mark abd/pel for rt perq,A,,3.48,10.25,,0.90,,0.36,14.09,4.74,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,79849412,,Ins device for rt guide open,A,,1.46,0.36,NA,0.36,,0.39,2.21,2.21,0,ZZZ,0.00,0.00,0.00,0,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,79949418,,Insert tun ip cath perc,A,,3.86,23.83,,0.93,,0.44,28.13,5.23,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00