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See a sample rate comparisonCPT 49406 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Surgery To Drain Fluid, Ultrasound Or Ct Scan Is Used To Locate A Fluid Collection (Abscess Cyst Etc) And To Provide Guidance For The Insertion Of A Needle Into The Affected Area. A Thin Tube (Catheter) Is Then Inserted And Used To Drain The Fluid.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None GC - Service performed by resident under supervision AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 49406 |
| Medicaid Fee Schedule | View Medicaid rates for 49406 |
National average reimbursement for CPT 49406 by major payers:
$941.71
$1,173.26
$1,281.87
$409.87
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CPT 49406
5 of 25 sample ratesHigher to lower in this preview
Bradley Trivax
University Associates In Obstetrics & Gynecology P C
$2,429.96Published rateLauri Romanzi
Jefferson University Physicians
$1,770.72Published rateMichelle Estep
Deaconess Hospital Inc
$1,474.61Published rateKaren Schoene
Amar Atwal, M.D., P.C.
$746.65Published rateKristin Whitley
Town Center Orthopaedic Associates, P.C.
$266.65Published rate
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See a sample payer proposalCPT 49406 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 49406 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 49406 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 49020-CPT | High | Drain Infection From Abdomen, Surgery To Drain Abscess (Pocket Of Infection) Located In The Peritoneum (Lining Of The Abdominal Cavity). |
| 49060-CPT | High | Drain Infection From Abdomen, Surgery To Drain Abscess (Pocket Of Infection) Located In The Peritoneum (Lining Of The Abdominal Cavity). |
| 49405-CPT | Moderate | Surgery To Drain Fluid, Ultrasound Or Ct Scan Is Used To Locate A Fluid Collection (Abscess Cyst Etc) And To Provide Guidance For The Insertion Of A Needle Into The Affected Area. A Thin Tube (Catheter) Is Then Inserted And Used To Drain The Fluid. |
| 49406-CPT | Moderate | Surgery To Drain Fluid, Ultrasound Or Ct Scan Is Used To Locate A Fluid Collection (Abscess Cyst Etc) And To Provide Guidance For The Insertion Of A Needle Into The Affected Area. A Thin Tube (Catheter) Is Then Inserted And Used To Drain The Fluid. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 49406. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 49406 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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