$926.03
Choose 49405 when the collection is within a visceral organ. Choose 49406 when the target is a collection in the peritoneal or retroperitoneal space.
On this page
CMS RVU26D · Effective 2026-10-01
49405 Visceral drainage Medicare reimbursement rates in Hawaii
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. Compare 49405 office and facility rates across CMS payment localities in Hawaii.
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 49405 in Hawaii?
Hawaii 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
$926.78
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$163.83
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Image-guided drainage
About 49405: Image-guided visceral collection drainage
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.
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.
CMS billing rules for 49405
- 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 RVU3.90 · 16%
- Practice expense (office) RVU20.76 · 83%
- Malpractice RVU0.42 · 2%
4.7K
Medicare services in 2024 · #1905 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.
49405 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$809.32
49407 describes collection drainage through a transvaginal or transrectal route. This code describes percutaneous catheter drainage of a visceral collection.
$615.24
49423 is for exchanging a drainage catheter already in place. This code is for image-guided percutaneous catheter drainage of a visceral collection.
Compare 49405 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
Hawaii, Guam →
Office / nonfacility
$926.78
Facility
$163.83
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 49405 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
5,794
- Code
- 49405
- Physician work
- 3.90
- Practice expense
- 20.76
- Malpractice
- 0.42
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.90 | × 1.000 | 3.9000 |
| Practice expense | 20.76 | × 1.137 | 23.6041 |
| Malpractice | 0.42 | × 0.579 | 0.2432 |
| Total RVUs | 27.7473 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$926.78
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.9 | 1 |
| Practice expense | 20.76 | 1.137 |
| Malpractice | 0.42 | 0.579 |
(3.9 × 1 + 20.76 × 1.137 + 0.42 × 0.579) × $33.4009 = $926.78
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.9 | 1 |
| Practice expense | 0.67 | 1.137 |
| Malpractice | 0.42 | 0.579 |
(3.9 × 1 + 0.67 × 1.137 + 0.42 × 0.579) × $33.4009 = $163.83
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.
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 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.
5,79149329,,Unlstd laps px abd pertm&omn,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,79249400,,Air injection into abdomen,A,,1.83,2.47,,0.31,,0.21,4.51,2.35,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,79349402,,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
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014