Find policies, billing codes, payers, states, and providers

CPT 44900: Incision and Drainage of Appendiceal Abscess

CPT code 44900 designates the surgical incision and drainage of an appendiceal abscess. This acute surgical procedure is performed to evacuate purulent material, relieve pain, and limit spread of infection, typically in an inpatient hospital setting. Nationally, timely management of intra-abdominal abscesses has implications for patient outcomes, length of stay, and downstream resource use.

Key payers in the national discussion include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for 44900, how the service is commonly delivered, and what benchmarks and policy themes are relevant to coverage and billing. Coverage aspects across major commercial and public payers, common billing considerations, and clinical setting expectations are summarized. The publication also outlines where to find related clinical and coding guidance and highlights common areas that affect claim adjudication and utilization, such as site of service and surgical urgency.

Data not available in the input for payer-specific rates, associated taxonomies, and ICD-10 diagnosis mappings are noted where applicable.

Customize your policy alerts

Sign up for cpt 44900 policy alerts

Get alerted when payer policies referencing 44900 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

CPT code 44900 describes the incision and drainage of an appendiceal abscess. The procedure involves surgically incising the abscess associated with the appendix and draining purulent material to relieve pain and control local infection.

Service type: Surgical drainage of intra-abdominal abscess related to the appendix
Typical site of service: Hospital operating room or hospital procedural area, often performed by general surgery teams

Find policies, billing codes, payers, states, and providers

CPT 44900: Incision and Drainage of Appendiceal Abscess

Data not available in the input for payer-specific rates, associated taxonomies, and ICD-10 diagnosis mappings are noted where applicable.

Customize your policy alerts

Sign up for cpt 44900 policy alerts

Get alerted when payer policies referencing 44900 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service type: Surgical drainage of intra-abdominal abscess related to the appendix
Typical site of service: Hospital operating room or hospital procedural area, often performed by general surgery teams

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult presenting to the emergency department with right lower quadrant abdominal pain, fever, localized tenderness, and an ultrasound or CT scan demonstrating a well-formed appendiceal abscess. The clinical workflow begins with triage and initial resuscitation, intravenous antibiotics, and imaging confirmation. Interventional radiology or a general surgeon evaluates the patient; when percutaneous drainage is not feasible or immediate source control is required, the provider performs an incision and drainage of the appendiceal abscess under appropriate anesthesia. Post-procedure care includes wound care, antibiotic management, culture of purulent material, pain control, and monitoring for sepsis. Documentation supports timing, indication (appendiceal abscess), procedure details (incision, pus drainage, drainage device if placed), anesthesia type, complications if any, and disposition (admission, observation, or discharge with outpatient follow-up).

Coding Specifications

Modifier	Description	When to Use
`00`	Default; no modifier	Used when no other modifier applies to the service.
`11`	Service performed by the billing provider	Used when the primary surgeon or performing provider directly performs the incision and drainage.
`22`	Increased procedural services	Used when documentation supports substantially greater work than typical for `44900`.
`52`	Reduced services	Used when the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Used when the procedure is started but discontinued due to patient instability or intraoperative findings.
`62`	Two surgeons	Used when two surgeons are required and both are documented as performing distinct portions of the procedure.
`78`	Return to the operating/procedure room for a related procedure during the postoperative period	Used when the patient returns to the OR for management of complications related to the original incision and drainage.
`80`	Assistant surgeon	Used when an assistant surgeon provides documented assistance during the procedure.
`81`	Minimum assistant surgeon	Used when a minimal assistant role is documented per payer rules.
`26`	Professional component	Rare for this procedure; used when a separate reporting for the professional interpretation component exists (example: imaging interpretation billed separately).
`51`	Multiple procedures	Used when `44900` is billed in addition to another separately reportable procedure during the same session; payers may require bundling rules review.
`22`	Note: repeated to emphasize relevance	See above entry for increased procedural services.
`52`	Note: repeated to emphasize relevance	See above entry for reduced services.

Taxonomy Code	Specialty	Notes
`207P00000X`	General Surgery	Most common specialty performing incision and drainage of appendiceal abscesses.
`2080S0002X`	Colon and Rectal Surgery	May manage intra-abdominal abscesses and complex appendiceal disease.
`3356M0002X`	Surgical Critical Care	Manages critically ill patients requiring operative source control.
`363L00000X`	Interventional Radiology	Performs percutaneous drainage as an alternative; collaborates when drainage catheter or image guidance is used.
`207K00000X`	Pediatric Surgery	Performs this procedure for pediatric patients when applicable.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K35.2`	Acute appendicitis with localized peritonitis	Represents acute appendicitis complicated by localized infection and abscess formation; common indication for `44900`.
`K36`	Other appendicitis	Includes atypical or unspecified appendicitis presentations that may progress to abscess requiring drainage.
`K37`	Unspecified appendicitis	Used when documentation does not specify type; may be associated with abscess if imaging supports.
`K65.2`	Peritoneal abscess	Directly relevant when an intra-abdominal abscess related to the appendix is present and requires drainage.
`R10.31`	Right lower quadrant pain	Symptom code commonly present in the clinical record supporting evaluation that leads to diagnosis requiring `44900`.
`A41.9`	Sepsis, unspecified organism	Used when systemic infection or sepsis occurs secondary to appendiceal rupture and abscess, justifying urgent source control.
`K66.1`	Hemoperitoneum (nontraumatic)	Included when intraperitoneal blood is present and complicates abscess management; less common but clinically relevant.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`49083`	Drainage of peritoneal abscess; percutaneous, without image guidance	Alternative percutaneous drainage approach; may be performed by interventional radiology instead of open incision and drainage.
`49084`	Drainage of peritoneal abscess; percutaneous, with image guidance	Used when image-guided catheter drainage is performed for appendiceal abscess management.
`44950`	Appendectomy, partial or total, with or without drainage	Performed when definitive removal of the appendix is undertaken either at the same setting or delayed after abscess management.
`10160`	Puncture aspiration of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess) with or without injection of antibiotic	Used for superficial abscesses; occasionally coded for simple superficial drainage if applicable in the abdominal wall.
`49560`	Drainage of incarcerated or strangulated abdominal wall hernia; complicated abscess or drainage procedures	May be billed if abscess extends into the abdominal wall or in cases with concurrent hernia repair issues.

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	Default; no modifier	Used when no other modifier applies to the service.
`11`	Service performed by the billing provider	Used when the primary surgeon or performing provider directly performs the incision and drainage.
`22`	Increased procedural services	Used when documentation supports substantially greater work than typical for `44900`.
`52`	Reduced services	Used when the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Used when the procedure is started but discontinued due to patient instability or intraoperative findings.
`62`	Two surgeons	Used when two surgeons are required and both are documented as performing distinct portions of the procedure.
`78`	Return to the operating/procedure room for a related procedure during the postoperative period	Used when the patient returns to the OR for management of complications related to the original incision and drainage.
`80`	Assistant surgeon	Used when an assistant surgeon provides documented assistance during the procedure.
`81`	Minimum assistant surgeon	Used when a minimal assistant role is documented per payer rules.
`26`	Professional component	Rare for this procedure; used when a separate reporting for the professional interpretation component exists (example: imaging interpretation billed separately).
`51`	Multiple procedures	Used when `44900` is billed in addition to another separately reportable procedure during the same session; payers may require bundling rules review.
`22`	Note: repeated to emphasize relevance	See above entry for increased procedural services.
`52`	Note: repeated to emphasize relevance	See above entry for reduced services.

Taxonomy Code	Specialty	Notes
`207P00000X`	General Surgery	Most common specialty performing incision and drainage of appendiceal abscesses.
`2080S0002X`	Colon and Rectal Surgery	May manage intra-abdominal abscesses and complex appendiceal disease.
`3356M0002X`	Surgical Critical Care	Manages critically ill patients requiring operative source control.
`363L00000X`	Interventional Radiology	Performs percutaneous drainage as an alternative; collaborates when drainage catheter or image guidance is used.
`207K00000X`	Pediatric Surgery	Performs this procedure for pediatric patients when applicable.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K35.2`	Acute appendicitis with localized peritonitis	Represents acute appendicitis complicated by localized infection and abscess formation; common indication for `44900`.
`K36`	Other appendicitis	Includes atypical or unspecified appendicitis presentations that may progress to abscess requiring drainage.
`K37`	Unspecified appendicitis	Used when documentation does not specify type; may be associated with abscess if imaging supports.
`K65.2`	Peritoneal abscess	Directly relevant when an intra-abdominal abscess related to the appendix is present and requires drainage.
`R10.31`	Right lower quadrant pain	Symptom code commonly present in the clinical record supporting evaluation that leads to diagnosis requiring `44900`.
`A41.9`	Sepsis, unspecified organism	Used when systemic infection or sepsis occurs secondary to appendiceal rupture and abscess, justifying urgent source control.
`K66.1`	Hemoperitoneum (nontraumatic)	Included when intraperitoneal blood is present and complicates abscess management; less common but clinically relevant.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`49083`	Drainage of peritoneal abscess; percutaneous, without image guidance	Alternative percutaneous drainage approach; may be performed by interventional radiology instead of open incision and drainage.
`49084`	Drainage of peritoneal abscess; percutaneous, with image guidance	Used when image-guided catheter drainage is performed for appendiceal abscess management.
`44950`	Appendectomy, partial or total, with or without drainage	Performed when definitive removal of the appendix is undertaken either at the same setting or delayed after abscess management.
`10160`	Puncture aspiration of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess) with or without injection of antibiotic	Used for superficial abscesses; occasionally coded for simple superficial drainage if applicable in the abdominal wall.
`49560`	Drainage of incarcerated or strangulated abdominal wall hernia; complicated abscess or drainage procedures	May be billed if abscess extends into the abdominal wall or in cases with concurrent hernia repair issues.

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 44900: Incision and Drainage of Appendiceal Abscess

Sign up for cpt 44900 policy alerts

Billing Code Overview

Catch payer policy changes before they impact reimbursement

Catch payer policy changes before they impact reimbursement

OpenPayer

CPT 44900: Incision and Drainage of Appendiceal Abscess

Sign up for cpt 44900 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

References

CPT 44900: Incision and Drainage of Appendiceal Abscess

Sign up for cpt 44900 policy alerts

Billing Code Overview

CPT 44900: Incision and Drainage of Appendiceal Abscess

Sign up for cpt 44900 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

What does CPT 44900 represent and where is it typically performed?

What clinical and documentation elements are important when billing 44900?

Which modifiers are commonly used with CPT 44900 and when are they applied?

What related CPT codes should be considered when an appendiceal abscess is managed?

Which diagnosis codes commonly support medical necessity for CPT 44900?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

What does CPT 44900 represent and where is it typically performed?

What clinical and documentation elements are important when billing 44900?

Which modifiers are commonly used with CPT 44900 and when are they applied?

What related CPT codes should be considered when an appendiceal abscess is managed?

Which diagnosis codes commonly support medical necessity for CPT 44900?

References