No office rate
49000 describes abdominal exploration. When exploration is performed to reach and drain the abscess, it is part of the operative service rather than a separate report with 49020.
On this page
CMS RVU26D · Effective 2026-10-01
49020 Abscess drainage Medicare reimbursement rates in Georgia
Reports open surgical drainage of a peritoneal abscess or localized peritonitis, excluding an abscess arising from the appendix. Compare 49020 office and facility rates across CMS payment localities in Georgia.
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 49020 in Georgia?
Georgia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1484.62–$1539.70
2 of 2 localities have a supported rate.
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.
General surgery
About 49020: Open drainage of peritoneal abscess
Reports open surgical drainage of a peritoneal abscess or localized peritonitis, excluding an abscess arising from the appendix.
The surgeon opens the abdomen to reach and drain a peritoneal abscess or area of localized peritonitis. The service may involve evacuating infected material, irrigating the cavity, and placing a drain as clinically indicated. General surgeons commonly perform it in a hospital operating room for a localized intra-abdominal infection requiring open treatment; it is not the code for an appendiceal abscess or a retroperitoneal collection.
Choose the code based on the documented infection site and open approach. The operative report should identify the abscess or localized peritonitis and describe its drainage. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. An assistant at surgery may be paid; co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 49020
- 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
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU26.00 · 58%
- Practice expense (office) RVU12.21 · 27%
- Malpractice RVU6.34 · 14%
3.2K
Medicare services in 2024 · #2133 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.
49020 compared with similar codes
Office rates for Georgia, from the same CMS release.
No office rate
Choose 49040 for an open-drained subphrenic or subdiaphragmatic abscess; 49020 covers a peritoneal abscess or localized peritonitis.
No office rate
Choose 49060 when the abscess is retroperitoneal. A peritoneal abscess or localized peritonitis treated through an open approach is described by 49020.
$262.68–$289.24
49083 is image-guided paracentesis for abdominal fluid, not open surgical drainage of a localized peritoneal abscess.
Compare 49020 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.
2 of 2 payment localities
Atlanta →
Office / nonfacility
Unavailable
Facility
$1539.70
Rest Of Georgia →
Office / nonfacility
Unavailable
Facility
$1484.62
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49020 billing questions
How does this differ from open drainage of a subphrenic abscess?
Use 49020 for a peritoneal abscess or localized peritonitis. A subphrenic or subdiaphragmatic abscess is reported with 49040.
Can 49020 be used for an appendiceal abscess?
No. The service described by 49020 excludes appendiceal abscess; select the applicable appendiceal procedure based on the operation performed.
Is abdominal exploration separately reported with the drainage?
Exploration performed to locate and reach the abscess is part of the open drainage service. Do not separately report 49000 for that operative access.
Should modifier 50 be appended for bilateral findings?
No. Modifier 50 is inappropriate for this service, and CMS makes no bilateral payment adjustment.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted under the CMS rules 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.
5,76349010,,Exploration behind abdomen,A,,15.66,6.34,NA,6.34,,3.88,25.88,25.88,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,76449013,,Prpertl pel pack hemrrg trma,A,,8.14,1.97,NA,1.97,,2.17,12.28,12.28,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,76549014,,Reexploration pelvic wound,A,,6.56,2.05,NA,2.05,,1.75,10.36,10.36,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,76649020,,Drainage abdom abscess open,A,,26.00,12.21,NA,12.21,,6.34,44.55,44.55,0,090,0.09,0.81,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,76749040,,Drain open abdom abscess,A,,16.11,8.45,NA,8.45,,4.15,28.71,28.71,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,76849060,,Drain open retroperi abscess,A,,18.07,8.41,NA,8.41,,4.24,30.72,30.72,0,090,0.09,0.81,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,76949062,,Drain to peritoneal cavity,A,,11.91,6.87,NA,6.87,,3.18,21.96,21.96,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00