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CMS RVU26D · Effective 2026-10-01

49040 Abscess drainage Medicare reimbursement rates in Indiana

Reports open surgical drainage of an abdominal abscess when the surgeon treats the collection through an operative approach rather than percutaneous catheter drainage. Compare 49040 office and facility rates across CMS payment localities in Indiana.

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 49040 in Indiana?

Indiana 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

$867.09

1 of 1 localities have a supported rate.

Payment area: Indiana

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.

Find 49040 in your payment locality →

Abdominal surgery

About 49040: Open abdominal abscess drainage

Reports open surgical drainage of an abdominal abscess when the surgeon treats the collection through an operative approach rather than percutaneous catheter drainage.

CPT 49040 reports operative access to and evacuation of a localized abdominal abscess through an open approach. A surgeon typically performs the procedure in a hospital operating room when the collection requires surgical exposure. The operative report should identify the abscess location and document that drainage was performed through an open approach.

Choose the code based on the documented site and method; compare 49020 for a peritoneal abscess and 49060 for a retroperitoneal abscess. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and related postoperative care through day 90. For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. Modifier 50 is inappropriate, and team surgery is not permitted.

CMS billing rules for 49040

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 paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU16.11 · 56%
  • Practice expense (office) RVU8.45 · 29%
  • Malpractice RVU4.15 · 14%

93

Medicare services in 2024 · #4936 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.

49040 compared with similar codes

Office rates for Indiana, from the same CMS release.

49020

Abscess drainage

Open peritoneal approach

No office rate

49020 is the comparison for a peritoneal abscess or localized peritonitis; 49040 applies when the documented abdominal abscess and open procedure fit 49040.

49060

Abscess drainage

Open approach

No office rate

Choose 49060 when the abscess is retroperitoneal. For 49040, the documentation must support the abdominal abscess service rather than the retroperitoneal site.

49062

Peritoneal drainage

Open surgical approach

No office rate

49040 describes open operative drainage. Consider 49062 only when the procedure is percutaneous and its site and service match that code.

Compare 49040 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

Office and facility base rates · shared scale starting at $0

  • Indiana →

    Office / nonfacility

    Unavailable

    Facility

    $867.09

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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 49040 in Indiana.

PPRRVU2026_Oct_nonQPP.csv

5,767

Code
49040
Physician work
16.11
Practice expense
8.45
Malpractice
4.15

GPCI2026.csv

52

Locality
Indiana
Physician work
1.000
Practice expense
0.927
Malpractice
0.486
Facility calculation for 49040 in Indiana
ComponentRVULocality factorAdjusted
Physician work16.11× 1.00016.1100
Practice expense8.45× 0.9277.8331
Malpractice4.15× 0.4862.0169
Total RVUs25.9600
Conversion factor× 33.4009

Facility rate, Indiana$867.09

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work16.111
Practice expense8.450.927
Malpractice4.150.486

(16.11 × 1 + 8.45 × 0.927 + 4.15 × 0.486) × $33.4009 = $867.09

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.

49040 billing questions

How does 49040 differ from 49020?

Use 49040 for open drainage of an abdominal abscess when its documented site and circumstances fit that code. Compare 49020 when the operative documentation identifies a peritoneal abscess or localized peritonitis.

When should 49060 be considered instead?

49060 is the code to compare when the abscess is documented as retroperitoneal. The operative report should support the anatomic site.

Does percutaneous catheter drainage qualify for 49040?

No. 49040 describes an open operative approach; a percutaneous procedure requires a code that matches its method and documented site.

How does the 90-day global period affect billing?

The day-before preoperative visit and related postoperative care through day 90 are included in the major-surgery global period.

Can assistant or co-surgeon services be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

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.

RVUs for 49040PPRRVU2026_Oct_nonQPP.csv, line 5,767 (RVU26D)
Geographic factors for IndianaGPCI2026.csv, line 52 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet