CPT code 46020: Seton placement, anal fistula2026 Medicare rate & RVUs in Hawaii, Guam, HI

In Hawaii, Guam, HI, Medicare pays $111.09 for 46020 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 46020 nationwide

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

What 46020 covers

A surgeon passes a loop through an anal fistula tract and secures it so the tract remains open for drainage. Colorectal and general surgeons commonly perform this procedure for fistulas managed in stages, including situations where immediate division of the tract is not the treatment plan. It is performed in an operating room or other procedural setting, depending on the patient and clinical circumstances.

Report 46020 for placing the seton, not for removing one or draining an abscess alone. The operative note should identify the fistula tract and document the seton placement. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery reporting 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.

How Hawaii, Guam, HI compares for 46020

Across 109 of 109 payment localities, the facility rate for 46020 runs from $99.64 in Arkansas to $138.22 in Alaska. Hawaii, Guam, HI pays $111.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

46020 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 46020 in every payment locality

How the 46020 rate is calculated

Each of 46020’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.

Payment rules and modifiers for 46020

The CMS indicators that decide how 46020 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 46020

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 46020 has changed in Hawaii, Guam, HI

Price 46020 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

• Ahuimanu
• Aiea
• Ainaloa
• Anahola
• Black Sands
• Captain Cook
• Discovery Harbour
• East Honolulu

Browse all communities in Hawaii

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

Open CMS sourceHow we calculate rates