Billing code 49406: Catheter drainageMedicare rate & RVUs in Ohio

Report percutaneous, image-guided catheter placement to drain a fluid collection in the peritoneal or retroperitoneal space.

CMS RVU26DEffective Oct 1, 20261 payment locality27.5K Medicare services in 2024

Medicare pays $776.87 for 49406 in the office in Ohio (Ohio). Which amount applies depends on the service address.

$776.87Office (non-facility)
$164.84Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 49406 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Ohio
  2. What 49406 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 49406 covers

This service places a catheter through the skin into a fluid collection in the peritoneal or retroperitoneal space so the collection can be drained. Typical cases include image-guided drainage of an abdominal abscess, hematoma, or cyst. An interventional radiologist commonly performs the procedure in a hospital imaging suite or other procedural setting, using imaging to guide access and catheter position.

Select this code when the collection is peritoneal or retroperitoneal; collections in a visceral organ or another specified access route belong to different codes. The report should identify the collection’s location and nature, the imaging guidance and access used, and catheter placement and drainage. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are 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.

49406 in Ohio

49406 office and facility rates by payment locality
Payment localityOfficeFacility
Ohio$776.87$164.84

How the 49406 rate is calculated

Each of 49406’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 · 49406

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.90Practice expense 20.74Malpractice 0.42

25.0600 adjusted RVUs×$33.4009 conversion factor=$837.03

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 49406

The CMS indicators that decide how 49406 is paid alongside other services.

CMS payment indicators · 49406

Catheter drainage

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49406 without 51 · national office

$837.03

Catheter drainage

49406-51 · Second procedure: 50%

$418.52

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%).

When to use modifier 51

49406 compared with similar codes

Compare codes

49406 vs 49405 vs 49407 vs 49083: national Medicare rates

Swap in your local Medicare rate.

  • 49406
    Catheter drainage · 3.9 wRVU
    $837.03
  • 49405
    Visceral drainage · 3.9 wRVU
    $837.69+$0.66
  • 49407
    Pelvic drainage · 4.14 wRVU
    $736.82−$100.21
  • 49083
    Paracentesis · 1.95 wRVU
    $284.24−$552.79

How to choose

49405Visceral drainage
Choose 49406 for a peritoneal or retroperitoneal collection; choose 49405 when the collection is in a visceral site.
49407Pelvic drainage
Code 49407 describes catheter drainage using a transvaginal or transrectal route, rather than percutaneous access to a peritoneal or retroperitoneal collection.
49083Paracentesis
Code 49083 is for image-guided abdominal paracentesis. Use 49406 when a catheter is placed to drain a peritoneal or retroperitoneal collection.

49406 billing questions

How does this differ from 49405?

Use 49406 for a peritoneal or retroperitoneal collection. Code 49405 is for a collection in a visceral site, such as an organ.

When is 49407 more appropriate?

Code 49407 is for catheter drainage reached through a transvaginal or transrectal route. Code 49406 covers percutaneous drainage of a peritoneal or retroperitoneal collection.

Can the imaging guidance be billed separately?

Image guidance is part of this catheter-drainage service. The procedure documentation should identify the guidance used and how it directed access and catheter placement.

Can modifier 50 be used for collections on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

How does the multiple-procedure rule affect another procedure in the same session?

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

Is an assistant or co-surgeon payable for this procedure?

Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted under the CMS rules provided for this code.

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
RVUs for 49406PPRRVU2026_Oct_nonQPP.csv, line 5,795 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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