Billing code 49423: Drain catheter exchangeMedicare rate & RVUs in Florida
Report this service when an existing percutaneous catheter draining an abscess, hematoma, seroma, or cyst is exchanged under fluoroscopic guidance.
Medicare pays $530.28–$577.98 for 49423 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 9 sections
What 49423 covers
This service exchanges an existing percutaneous catheter used to drain a fluid collection, such as an abscess, hematoma, seroma, or cyst. An interventional radiologist typically removes the existing catheter and places a replacement through the established access, using fluoroscopy and contrast injection to assess the catheter and collection. The procedure is commonly performed in a hospital radiology suite or another setting equipped for image-guided intervention.
Report the exchange when a catheter is already in place and is replaced, rather than when a new drainage catheter is initially placed. The record should identify the collection and existing catheter, explain the reason for exchange, and document the replacement and imaging. Contrast injection and fluoroscopic guidance with radiological supervision and interpretation are included. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 49423 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$530.28 to $577.98
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $560.22 | $65.21 |
| Miami | $577.98 | $69.29 |
| Rest Of Florida | $530.28 | $63.13 |
How the 49423 rate is calculated
Each of 49423’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 · 49423
RVUs × geographic indexes × conversion factor
Work1.42
1.42 RVUs× 1.000 GPCI
Practice expense14.87
14.87 RVUs× 1.000 GPCI
Malpractice0.16
0.16 RVUs× 1.000 GPCI
Adjusted RVUs
16.4500
Conversion factor
$33.4009
Medicare rate
$549.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49423
The CMS indicators that decide how 49423 is paid alongside other services.
CMS payment indicators · 49423
Drain catheter exchange
| 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) | 0 | Not paid without supporting documentation. |
| 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
49423 without 51 · national office
$549.44
Drain catheter exchange
49423-51 · Second procedure: 50%
$274.72
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%).
49423 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 49405Visceral drainage
- 49405 reports placement of a new catheter to drain a visceral collection. Use 49423 when an existing percutaneous drainage catheter is exchanged.
- 49406Catheter drainage
- 49406 is for new catheter placement in a peritoneal or retroperitoneal collection. It does not describe replacement of a catheter already in place.
- 49407Pelvic drainage
- 49407 describes new catheter placement through a transrectal or transvaginal route. 49423 describes exchange of an existing percutaneous drainage catheter.
- 49424Cavity contrast study
- 49424 covers contrast evaluation through an existing drainage catheter without an exchange. 49423 is reported when the catheter itself is replaced.
49423 billing questions
When should this code be chosen instead of 49405, 49406, or 49407?
Use 49423 for exchanging a catheter already draining a collection. Codes 49405, 49406, and 49407 describe image-guided placement of a drainage catheter, with the applicable code determined by the collection site.
Is the fluoroscopic contrast assessment separately reported?
Fluoroscopic guidance, contrast injection, and radiological supervision and interpretation are included in the exchange service.
Can modifier 50 be used for an exchange on both sides?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How does Medicare handle this service when other procedures occur in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
What documentation supports reporting the exchange?
Document the collection and existing catheter, the reason it needed replacement, the catheter exchange performed, and the fluoroscopic and contrast assessment.
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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