$759.53
Choose 49405 for image-guided percutaneous drainage of a visceral collection. Choose 49185 when the collection is treated with a sclerosant.
On this page
CMS RVU26D · Effective 2026-10-01
49185 Fluid collection treatment Medicare reimbursement rates in Kentucky
Report percutaneous sclerotherapy when a clinician treats a defined fluid collection, such as a lymphocele, cyst, or seroma, by instilling a sclerosant. Compare 49185 office and facility rates across CMS payment localities in Kentucky.
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 49185 in Kentucky?
Kentucky 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
$1081.28
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$102.28
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Interventional radiology
About 49185: Percutaneous fluid collection sclerotherapy
Report percutaneous sclerotherapy when a clinician treats a defined fluid collection, such as a lymphocele, cyst, or seroma, by instilling a sclerosant.
This service treats a defined fluid collection by percutaneously placing a needle or catheter and instilling a sclerosant to promote closure of the cavity. Typical targets include a lymphocele, cyst, or seroma. An interventional radiologist commonly performs the procedure in a hospital or outpatient setting, using imaging to access and treat the collection. The service includes contrast injection and radiological supervision and interpretation.
Report 49185 when the procedure is sclerotherapy of a fluid collection, rather than drainage alone, tissue sampling, or open removal. Documentation should identify the collection, describe percutaneous access and sclerosant treatment, and support the imaging and contrast work performed. The code has a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 49185
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- 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 RVU2.29 · 6%
- Practice expense (office) RVU33.53 · 93%
- Malpractice RVU0.30 · 1%
3K
Medicare services in 2024 · #2186 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.
49185 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$758.94
Choose 49406 for image-guided percutaneous drainage of a peritoneal or retroperitoneal collection; 49185 describes sclerotherapy instead.
$157.86
49180 is for biopsy of an abdominal mass to obtain tissue. It is not the code for sclerosing a fluid collection.
Compare 49185 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
Kentucky →
Office / nonfacility
$1081.28
Facility
$102.28
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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 49185 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
5,774
- Code
- 49185
- Physician work
- 2.29
- Practice expense
- 33.53
- Malpractice
- 0.30
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.29 | × 1.000 | 2.2900 |
| Practice expense | 33.53 | × 0.889 | 29.8082 |
| Malpractice | 0.30 | × 0.915 | 0.2745 |
| Total RVUs | 32.3727 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$1081.28
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.29 | 1 |
| Practice expense | 33.53 | 0.889 |
| Malpractice | 0.3 | 0.915 |
(2.29 × 1 + 33.53 × 0.889 + 0.3 × 0.915) × $33.4009 = $1081.28
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.29 | 1 |
| Practice expense | 0.56 | 0.889 |
| Malpractice | 0.3 | 0.915 |
(2.29 × 1 + 0.56 × 0.889 + 0.3 × 0.915) × $33.4009 = $102.28
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.
49185 billing questions
When should 49185 be selected instead of a fluid-collection drainage code?
Use 49185 when the clinician performs percutaneous sclerotherapy to treat the collection. Drainage codes describe catheter drainage, not sclerosant treatment.
Are imaging guidance and contrast reported separately?
The service includes contrast injection and radiological supervision and interpretation. Do not separately report those elements as separate services for the same sclerotherapy procedure.
Can modifier 50 be used for collections on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant, co-surgeon, or surgical team be paid?
Medicare does not pay an assistant at surgery for 49185. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 49185?
Document the type and location of the collection, percutaneous access, sclerosant treatment, and imaging and contrast work. The record should make clear that the service was sclerotherapy rather than drainage alone.
What care is included in the global period?
The code has a 0-day global period. Same-day preoperative and postoperative care is included.
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.
5,77149083,,Abd paracentesis w/imaging,A,,1.95,6.35,,0.62,,0.21,8.51,2.78,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77249084,,Peritoneal lavage,A,,1.95,0.46,NA,0.46,,0.46,2.87,2.87,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77349180,,Biopsy abdominal mass,A,,1.69,3.23,,0.26,,0.18,5.10,2.13,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77449185,,Sclerotx fluid collection,A,,2.29,33.53,,0.56,,0.30,36.12,3.15,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77549186,,Opn exc/dstr ntra-abd 5 cm/<,A,,21.45,10.28,NA,10.28,,4.84,36.57,36.57,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77649187,,Opn exc/dstr ntra-abd 5.1-10,A,,27.93,11.95,NA,11.95,,6.42,46.30,46.30,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77749188,,Opn exc/dst ntra-abd 10.1-20,A,,33.15,14.67,NA,14.67,,7.64,55.46,55.46,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631