$741.64–$804.44
49405 reports placement of a new catheter to drain a visceral collection. Use 49423 when an existing percutaneous drainage catheter is exchanged.
On this page
CMS RVU26D · Effective 2026-10-01
49423 Drain catheter exchange Medicare reimbursement rates in Missouri
Report this service when an existing percutaneous catheter draining an abscess, hematoma, seroma, or cyst is exchanged under fluoroscopic guidance. Compare 49423 office and facility rates across CMS payment localities in Missouri.
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 49423 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$480.77–$525.62
3 of 3 localities have a supported rate.
Facility setting
$59.54–$60.42
3 of 3 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.
Where 49423 pays more and less in Missouri
3 payment localities
$480.77 to $525.62
Interventional radiology
About 49423: Percutaneous drainage catheter exchange
Report this service when an existing percutaneous catheter draining an abscess, hematoma, seroma, or cyst is exchanged under fluoroscopic guidance.
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.
CMS billing rules for 49423
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.42 · 9%
- Practice expense (office) RVU14.87 · 90%
- Malpractice RVU0.16 · 1%
8.1K
Medicare services in 2024 · #1583 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.
49423 compared with similar codes
Office rates for Missouri, from the same CMS release.
$741.06–$803.80
49406 is for new catheter placement in a peritoneal or retroperitoneal collection. It does not describe replacement of a catheter already in place.
$656.13–$708.95
49407 describes new catheter placement through a transrectal or transvaginal route. 49423 describes exchange of an existing percutaneous drainage catheter.
$151.09–$164.11
49424 covers contrast evaluation through an existing drainage catheter without an exchange. 49423 is reported when the catheter itself is replaced.
Compare 49423 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
$519.02
Facility
$60.18
Metropolitan St. Louis →
Office / nonfacility
$525.62
Facility
$60.42
Rest Of Missouri →
Office / nonfacility
$480.77
Facility
$59.54
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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 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.
5,80049419,,Insert tun ip cath w/port,A,,6.90,3.23,NA,3.23,,1.59,11.72,11.72,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80149421,,Ins tun ip cath for dial opn,A,,4.10,1.06,NA,1.06,,1.03,6.19,6.19,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80249422,,Remove tunneled ip cath,A,,3.90,1.18,NA,1.18,,0.96,6.04,6.04,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80349423,,Exchange drainage catheter,A,,1.42,14.87,,0.24,,0.16,16.45,1.82,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80449424,,Assess cyst contrast inject,A,,0.74,4.31,,0.15,,0.07,5.12,0.96,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80549425,,Insert abdomen-venous drain,A,,11.91,7.26,NA,7.26,,3.18,22.35,22.35,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,80649426,,Revise abdomen-venous shunt,A,,10.15,6.38,NA,6.38,,2.71,19.24,19.24,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00