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    OpenPayerBilling CodesDrainage Catheter ProceduresCPT cpt-49424-catheter-contrast-injection-abscess-evaluation
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    CPT 49424: Contrast Injection via Drainage Catheter for Abscess/Cyst

    Medicare pays $178 on average nationally for this procedure.

    CPT code 49424 describes injection of contrast material through an existing drainage catheter to visualize and assess the size, type, and location of an abscess or cyst; service type: contrast injection/contrast study via indwelling drainage catheter; typical site of service: radiology suite, interventional radiology or hospital inpatient/outpatient setting where drainage catheters are managed.

    For related coverage guidance, see recent payer policy updates: Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders, Esophagogastroduodenoscopy (EGD) Coverage Policy, Radiofrequency Therapy for Fecal Incontinence.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 54-year-old male with a previously placed percutaneous abscess drainage catheter for a complex intra-abdominal abscess following diverticulitis. The drain has been in place for several days and drainage has decreased; the surgical team requests contrast injection through the existing catheter to define the cavity size, assess for residual loculations or fistulous communication, and confirm catheter position before deciding on catheter removal or exchange. The procedure is performed in an interventional radiology suite or at bedside if portable fluoroscopy or ultrasound guidance is available. The workflow includes review of prior imaging and indications, informed consent, sterile preparation of the catheter site, slow injection of water-soluble contrast via the catheter under fluoroscopic (or CT/ultrasound-assisted) visualization, acquisition of images to delineate cavity morphology and any communicating tracts, interpretation by the performing physician, and documentation of findings and plan (e.g., catheter retention, repositioning, exchange, or removal). Typical staff include the interventional radiologist or surgeon, a radiology technologist, and nursing support for monitoring and sterile assistance. The typical site of service is the hospital outpatient or inpatient radiology/interventional suite; bedside procedures may occur in the inpatient ward or ICU when imaging support is available.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    49424Injection of contrast material into existing drainage catheter for evaluation of abscess or cystThis is the primary procedure code describing the targeted contrast injection study through an indwelling drain to assess size, loculation, and communication of the cavity.
    49422Percutaneous placement of drainage catheter, percutaneous, with imaging guidanceOften performed before 49424; initial catheter placement to drain abscesses which may later require contrast injection for reassessment.
    77012Fluoroscopic guidance and localization of needle or catheter for contrast injectionFrequently reported when fluoroscopic imaging guidance is separately billable to localize catheters during contrast injection studies if payer allows.
    71260CT chest with contrast (single or multiphase)CT imaging may be performed in conjunction with contrast injection through a catheter to better delineate cavity anatomy and fistulous tracts.
    74170CT abdomen and pelvis with contrastOften performed before or after catheter contrast injection to provide cross-sectional correlation of the abscess cavity and surrounding structures.
    76937Ultrasound guidance for drain evaluation or injectionUltrasound guidance may be used instead of fluoroscopy for bedside contrast injection into superficial collections.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207P00000X
    363A00000X
    208000000X
    261QM1103X
    204C00000X
    246ZB0600X
    224Z00000X
    207NS0135X

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Radiofrequency Therapy for Fecal IncontinenceCigna2026-10-15
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    High-Resolution Anoscopy (HRA)Premera Bluecross2026-10-01
    Gastroesophageal and Gastrointestinal (GI) Services and ProceduresColorado Rocky Mountain Health Plans2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01

    Related Codes

    CPT-49423-ABDOMINAL-DRAINAGE-CATHETER-EXCHANGE

    CPT 49423: Percutaneous Abdominal Catheter Exchange for Drainage

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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