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CPT code 46030: Seton removal, noncutting seton2026 Medicare rate & RVUs in Queens, NY

Report removal of a noncutting anal seton, commonly a loose drainage seton, when the clinician removes it from an anal fistula tract.

CMS RVU26DEffective Oct 1, 2026One payment locality355 Medicare services in 2024

In Queens, NY, Medicare pays $331.99 for 46030 in the office and $91.56 when it’s performed in a hospital or facility.

$331.99Office (non-facility)
$91.56Hospital or facility
+16.9%vs the national office rate ($283.91)

Check a contract rate as a % of Medicare · 46030 nationwide

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

We’ll open 46030 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 46030 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 46030 covers

This service covers removing a noncutting seton from an anal fistula tract, often after it has maintained drainage or controlled inflammation. A colorectal or general surgeon may remove a loose seton in an office or procedure setting, or during an operative encounter. The service is removal only; placement of a seton or operative treatment of the fistula describes different work.

Document the seton’s removal and the clinical status of the fistula tract. The code has 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 the others at 50%. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery 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 Queens, NY compares for 46030

Across 109 of 109 payment localities, the office rate for 46030 runs from $247.90 in Arkansas to $386.16 in San Benito County, CA. Queens, NY pays $331.99. The RVUs are the same everywhere; the geographic indexes change the dollars.

46030 in Queens, NY vs other payment areas
  1. Queens, NY · this page$331.99
  2. Manhattan, NY · New York$328.59−$3.40
  3. NYC suburbs and Long Island, NY · New York$336.91+$4.92
  4. Poughkeepsie and northern NYC suburbs, NY · New York$309.40−$22.59
  5. Rest of New York · New York$270.14−$61.85
  6. Los Angeles, CA · California$324.87−$7.12
  7. Washington, DC area · District of Columbia$327.96−$4.03

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

46030 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$305.50$93.75
Chicago, ILIllinois$295.76$91.34
AlaskaAlaska$319.16$102.53
AlabamaAlabama$251.95$73.97
ArkansasArkansas$247.90$73.17
ArizonaArizona$275.69$78.59
Bakersfield, CACalifornia$303.56$80.62
Chico, CACalifornia$302.87$79.94

46030 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$247.90

$344.52

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
46030 office rate range by state
State / territoryOffice rate rangeLocalities
AK$319.161
AL$251.951
AR$247.901
AZ$275.691
CA$302.87–$386.1629
CO$297.311
CT$304.091
DC$327.961
DE$280.601
FL$277.92–$305.503
GA$260.84–$289.312
GU$311.741
HI$311.741
IA$259.711
ID$261.461
IL$268.60–$296.584
IN$263.161
KS$258.061
KY$257.941
LA$257.37–$271.562
MA$295.12–$329.192
MD$286.46–$327.963
ME$262.65–$278.902
MI$265.12–$281.432
MN$284.871
MO$252.26–$272.993
MS$250.151
MT$283.891
NC$265.751
ND$279.151
NE$261.381
NH$292.251
NJ$307.57–$323.932
NM$266.611
NV$282.801
NY$270.14–$336.915
OH$264.151
OK$257.751
OR$280.62–$307.912
PA$264.79–$295.662
PR$286.291
RI$291.471
SC$265.391
SD$278.581
TN$259.471
TX$262.84–$296.308
UT$269.421
VA$277.68–$327.962
VI$286.291
VT$277.671
WA$294.69–$336.552
WI$268.791
WV$257.521
WY$281.821

See 46030 in every payment locality

How the 46030 rate is calculated

Each of 46030’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 · 46030

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.44

1.44 RVUs× 1.000 GPCI

Practice expense6.82

6.82 RVUs× 1.000 GPCI

Malpractice0.24

0.24 RVUs× 1.000 GPCI

Adjusted RVUs

8.5000

Conversion factor

$33.4009

Medicare rate

$283.91

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,571

Code
46030
Physician work
1.44
Practice expense
6.82
Malpractice
0.24

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 46030 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work1.44× 1.0641.5322
Practice expense6.82× 1.1828.0612
Malpractice0.24× 1.4420.3461
Total RVUs9.9395
Conversion factor× 33.4009

Office rate, Queens, NY$331.99

Office: (1.44 × 1.064 + 6.82 × 1.182 + 0.24 × 1.442) × $33.4009 = $331.99

Facility: (1.44 × 1.064 + 0.73 × 1.182 + 0.24 × 1.442) × $33.4009 = $91.56

Open 46030 in the RVU calculator

Payment rules and modifiers for 46030

The CMS indicators that decide how 46030 is paid alongside other services.

CMS payment indicators · 46030

Seton removal, noncutting seton

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

46030 without 51 · national office

$283.91

Seton removal, noncutting seton

46030-51 · Second procedure: 50%

$141.96

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%).

When to use modifier 51

Codes related to 46030

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

Codes related to 46030
CodeHow it relatesOffice range, Queens, NY
Same family
46020Seton placement, anal fistulaSeton placement rather than removal.No office rate
Used instead
46200Fissure surgery, fissure excisionFistulotomy is reported for operative treatment of the fistula, not removal alone.$618.75
46280Anal fistula surgery, complex sphincter-crossing tractSurgical treatment of a complex fistula is distinct from removing a seton alone.No office rate

How 46030 has changed in Queens, NY

46030 · Office / nonfacility

$331.99

Effective 2026-10-01

The base rate is $44.69 higher than on 2025-10-01, moving from $287.30 to $331.99 (15.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $287.30changed to$331.99

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.48 changed to 1.44
    • Practice expense RVU 5.82 changed to 6.82
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $298.44changed to$287.30

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.89 changed to 5.82

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $293.57changed to$298.44

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $317.10changed to$293.57

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.00 changed to 5.89
    • Malpractice RVU 0.25 changed to 0.24
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $335.91changed to$317.10

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.09 changed to 6.00
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $198.33changed to$335.91

    • Conversion factor 34.8931 changed to 34.6062
    • Work RVU 1.26 changed to 1.48
    • Practice expense RVU 3.09 changed to 6.09
    • Malpractice RVU 0.21 changed to 0.25

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $183.02changed to$198.33

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.65 changed to 3.09
    • Malpractice RVU 0.22 changed to 0.21
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $175.30changed to$183.02

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.56 changed to 2.65
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $174.24changed to$175.30

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.54 changed to 2.56

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $172.56changed to$174.24

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.49 changed to 2.54
    • Malpractice RVU 0.23 changed to 0.22
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $172.31changed to$172.56

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $173.37changed to$172.31

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.50 changed to 2.49

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $172.50changed to$173.37

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $168.09changed to$172.50

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.47 changed to 2.50
    • Malpractice RVU 0.22 changed to 0.23
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $170.63changed to$168.09

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.79 changed to 2.47
    • Malpractice RVU 0.23 changed to 0.22
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $170.63

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$331.99$91.56RVU26D
2026-07-01$331.99$91.56RVU26C
2026-04-01$331.99$91.56RVU26B
2026-01-01$331.99$91.56RVU26A
2025-10-01$287.30$97.12RVU25D
2025-07-01$287.30$97.12RVU25C
2025-04-01$287.30$97.12RVU25B
2025-01-01$287.30$97.12RVU25A
2024-10-01$298.44$98.76RVU24D
2024-07-01$298.44$98.76RVU24C
2024-04-01$298.44$98.76RVU24B
2024-03-09$298.44$98.76RVU24AR
2024-01-01$293.57$97.14RVU24A
2023-10-01$317.10$105.99RVU23D
2023-07-01$317.10$105.99RVU23C
2023-04-01$317.10$105.99RVU23B
2023-01-01$317.10$105.99RVU23A
2022-10-01$335.91$112.80RVU22D
2022-07-01$335.91$112.80RVU22C
2022-04-01$335.91$112.80RVU22B
2022-01-01$335.91$112.80RVU22A
2021-10-01$198.33$116.06RVU21D
2021-07-01$198.33$116.06RVU21C
2021-04-01$198.33$116.06RVU21B
2021-01-01$198.33$116.06RVU21A
2020-10-01$183.02$115.54RVU20D
2020-07-01$183.02$115.54RVU20C
2020-04-01$183.02$115.54RVU20B
2020-01-01$183.02$115.54RVU20A
2019-10-01$175.30$112.59RVU19D
2019-07-01$175.30$112.59RVU19C
2019-04-01$175.30$112.59RVU19B
2019-01-01$175.30$112.59RVU19A
2018-10-01$174.24$112.90RVU18D
2018-07-01$174.24$112.90RVU18C
2018-04-01$174.24$112.90RVU18B
2018-01-01$174.24$112.90RVU18AR1
2017-10-01$172.56$113.56RVU17D
2017-07-01$172.56$113.56RVU17C
2017-04-01$172.56$113.56RVU17B
2017-01-01$172.56$113.56RVU17A
2016-10-01$172.31$113.07RVU16D
2016-07-01$172.31$113.07RVU16C
2016-04-01$172.31$113.07RVU16B
2016-01-01$172.31$113.07RVU16A
2015-10-01$173.37$113.91RVU15D
2015-07-01$173.37$113.91RVU15C
2015-04-01$172.50$113.34RVU15B
2015-01-01$172.50$113.34RVU15A
2014-10-01$168.09$110.20RVU14D
2014-07-01$168.09$110.20RVU14C
2014-04-01$168.09$110.20RVU14B
2014-01-01$168.09$110.20RVU14A
2013-10-01$170.63$107.61RVU13D
2013-07-01$170.63$107.61RVU13C
2013-04-01$170.63$107.61RVU13B
2013-01-01$170.63$107.61RVU13AR

Price 46030 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

46030 billing questions

How is removal different from seton placement?

46030 describes taking out a noncutting seton. Use 46020 when the service is placement of a seton.

Is this the code for fistulotomy or definitive fistula surgery?

No. Report 46030 for seton removal itself; operative fistula treatment, such as fistulotomy, is a different service.

Can modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How are same-session procedures paid?

The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction.

What documentation supports reporting 46030?

Document that a noncutting anal seton was removed and describe the fistula tract’s status. Same-day preoperative and postoperative care is included in the 0-day global period.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.

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
RVUs for 46030PPRRVU2026_Oct_nonQPP.csv, line 5,571 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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