Billing code 49020: Abscess drainageMedicare rate & RVUs in Texas
Reports open surgical drainage of a peritoneal abscess or localized peritonitis, excluding an abscess arising from the appendix.
CMS doesn’t publish an office rate for 49020 in Texas.
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 49020 covers
The surgeon opens the abdomen to reach and drain a peritoneal abscess or area of localized peritonitis. The service may involve evacuating infected material, irrigating the cavity, and placing a drain as clinically indicated. General surgeons commonly perform it in a hospital operating room for a localized intra-abdominal infection requiring open treatment; it is not the code for an appendiceal abscess or a retroperitoneal collection.
Choose the code based on the documented infection site and open approach. The operative report should identify the abscess or localized peritonitis and describe its drainage. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. An assistant at surgery may be paid; co-surgeon and team-surgery billing 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.
Where 49020 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,489.26 |
| Beaumont | Unavailable | $1,436.27 |
| Brazoria | Unavailable | $1,444.70 |
| Dallas | Unavailable | $1,464.12 |
| Fort Worth | Unavailable | $1,462.80 |
| Galveston | Unavailable | $1,455.68 |
| Houston | Unavailable | $1,571.73 |
| Rest Of Texas | Unavailable | $1,446.67 |
How the 49020 rate is calculated
Each of 49020’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 · 49020
RVUs × geographic indexes × conversion factor
Work26.00
26.00 RVUs× 1.000 GPCI
Practice expense12.21
12.21 RVUs× 1.000 GPCI
Malpractice6.34
6.34 RVUs× 1.000 GPCI
Adjusted RVUs
44.5500
Conversion factor
$33.4009
Medicare rate
$1,488.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49020
49020 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49020
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) | 0 | Not permitted. |
| 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 · 49020
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
49020 without 51 · national facility
$1,488.01
Abscess drainage
49020-51 · Second procedure: 50%
$744.01
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%).
49020 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 49000Abdominal exploration
- 49000 describes abdominal exploration. When exploration is performed to reach and drain the abscess, it is part of the operative service rather than a separate report with 49020.
- 49040Abscess drainage
- Choose 49040 for an open-drained subphrenic or subdiaphragmatic abscess; 49020 covers a peritoneal abscess or localized peritonitis.
- 49060Abscess drainage
- Choose 49060 when the abscess is retroperitoneal. A peritoneal abscess or localized peritonitis treated through an open approach is described by 49020.
- 49083Paracentesis
- 49083 is image-guided paracentesis for abdominal fluid, not open surgical drainage of a localized peritoneal abscess.
49020 billing questions
How does this differ from open drainage of a subphrenic abscess?
Use 49020 for a peritoneal abscess or localized peritonitis. A subphrenic or subdiaphragmatic abscess is reported with 49040.
Can 49020 be used for an appendiceal abscess?
No. The service described by 49020 excludes appendiceal abscess; select the applicable appendiceal procedure based on the operation performed.
Is abdominal exploration separately reported with the drainage?
Exploration performed to locate and reach the abscess is part of the open drainage service. Do not separately report 49000 for that operative access.
Should modifier 50 be appended for bilateral findings?
No. Modifier 50 is inappropriate for this service, and CMS makes no bilateral payment adjustment.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted under the CMS rules 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
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