Billing code 49040: Abscess drainageMedicare rate & RVUs in Nebraska
Reports open surgical drainage of an abdominal abscess when the surgeon treats the collection through an operative approach rather than percutaneous catheter drainage.
CMS doesn’t publish an office rate for 49040 in Nebraska.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 49040 covers
billing code 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.
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 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | Unavailable | $850.99 |
How the 49040 rate is calculated
Each of 49040’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 49040
RVUs × geographic indexes × conversion factor
Work16.11
16.11 RVUs× 1.000 GPCI
Practice expense8.45
8.45 RVUs× 1.000 GPCI
Malpractice4.15
4.15 RVUs× 1.000 GPCI
Adjusted RVUs
28.7100
Conversion factor
$33.4009
Medicare rate
$958.94
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49040
49040 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49040
Abscess drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 49040
Abscess drainage
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49040 without 51 · national facility
$958.94
Abscess drainage
49040-51 · Second procedure: 50%
$479.47
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
49040 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 49020Abscess drainage
- 49020 is the comparison for a peritoneal abscess or localized peritonitis; 49040 applies when the documented abdominal abscess and open procedure fit 49040.
- 49060Abscess drainage
- Choose 49060 when the abscess is retroperitoneal. For 49040, the documentation must support the abdominal abscess service rather than the retroperitoneal site.
- 49062Peritoneal drainage
- 49040 describes open operative drainage. Consider 49062 only when the procedure is percutaneous and its site and service match that code.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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