No office rate
49323 is for operative drainage of a lymphocele; 49322 is for laparoscopic aspiration of a collection.
On this page
CMS RVU26D · Effective 2026-10-01
49323 Lymphocele drainage Medicare reimbursement rates in Alabama
Report laparoscopic operative drainage when a surgeon treats a lymphocele, often a symptomatic postoperative collection, through abdominal ports. Compare 49323 office and facility rates across CMS payment localities in Alabama.
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 49323 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$546.27
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
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.
Laparoscopic surgery
About 49323: Laparoscopic lymphocele drainage
Report laparoscopic operative drainage when a surgeon treats a lymphocele, often a symptomatic postoperative collection, through abdominal ports.
This code represents operative laparoscopic treatment of a lymphocele, a postoperative lymphatic fluid collection, by opening the collection to establish drainage. Surgeons may encounter symptomatic pelvic lymphoceles after pelvic lymph-node dissection or in transplant patients; the laparoscope allows inspection and treatment through abdominal ports. General, gynecologic, urologic, or transplant surgeons may perform the procedure in a hospital operating room.
Select 49323 when the operative work is directed to draining a lymphocele, rather than merely sampling it or aspirating a collection. The operative report should identify the collection as a lymphocele, document its location and the laparoscopic approach, and describe the drainage performed. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. When related endoscopies are performed together, endoscopy-family pricing applies. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not. Modifier 50 is inappropriate.
CMS billing rules for 49323
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.97 · 55%
- Practice expense (office) RVU5.79 · 32%
- Malpractice RVU2.33 · 13%
351
Medicare services in 2024 · #3859 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.
49323 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
49320 describes diagnostic laparoscopic inspection. Choose 49323 when the surgeon performs therapeutic drainage of a lymphocele.
49329
No office rateUnlstd laps px abd pertm&omn
49329 is an unlisted laparoscopic code. Use 49323 when the documented procedure is laparoscopic drainage of a lymphocele.
Compare 49323 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.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$546.27
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 49323 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
5,786
- Code
- 49323
- Physician work
- 9.97
- Practice expense
- 5.79
- Malpractice
- 2.33
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.97 | × 1.000 | 9.9700 |
| Practice expense | 5.79 | × 0.875 | 5.0663 |
| Malpractice | 2.33 | × 0.566 | 1.3188 |
| Total RVUs | 16.3550 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$546.27
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.97 | 1 |
| Practice expense | 5.79 | 0.875 |
| Malpractice | 2.33 | 0.566 |
(9.97 × 1 + 5.79 × 0.875 + 2.33 × 0.566) × $33.4009 = $546.27
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
49323 billing questions
When should 49323 be chosen over 49322?
Use 49323 for operative laparoscopic drainage of a lymphocele. Code 49322 describes laparoscopic aspiration, which removes fluid by suction rather than establishing operative drainage.
Can diagnostic laparoscopy be reported separately with 49323?
Do not separately report diagnostic laparoscopy solely for inspection or access during the same operative session in which the lymphocele is drained.
What documentation supports 49323?
Document that the treated collection is a lymphocele, its location, the laparoscopic approach, and the operative steps used to drain it.
Does modifier 50 apply to bilateral lymphoceles?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used.
How does the 90-day global affect postoperative care?
The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made, and co-surgeons are permitted. Team surgery is not permitted 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 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.
5,78349320,,Diag laparo separate proc,A,,5.01,3.23,NA,3.23,,1.23,9.47,9.47,0,010,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78449321,,Laparoscopy biopsy,A,,5.30,3.30,NA,3.30,,1.26,9.86,9.86,0,010,0.10,0.80,0.10,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
5,78549322,,Laparoscopy aspiration,A,,5.86,3.36,NA,3.36,,1.42,10.64,10.64,0,010,0.10,0.80,0.10,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
5,78649323,,Laparo drain lymphocele,A,,9.97,5.79,NA,5.79,,2.33,18.09,18.09,0,090,0.10,0.80,0.10,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
5,78749324,,Lap insert tunnel ip cath,A,,6.16,3.19,NA,3.19,,1.61,10.96,10.96,0,010,0.10,0.80,0.10,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
5,78849325,,Lap revision perm ip cath,A,,6.65,3.26,NA,3.26,,1.73,11.64,11.64,0,010,0.10,0.80,0.10,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
5,78949326,,Lap w/omentopexy add-on,A,,3.41,0.76,NA,0.76,,0.90,5.07,5.07,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515