CPT code 46040: Abscess drainage, ischiorectal or intramural2026 Medicare rate & RVUs in South Carolina

In South Carolina, Medicare pays $592.71 for 46040 in the office and $412.16 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 46040 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 46040 covers

This operation drains an abscess in the ischiorectal space or within the rectal wall through an external incision. A general or colorectal surgeon typically performs it in an operating room or, when clinically appropriate, another procedure setting. The surgeon opens the infected cavity, evacuates its contents, and provides drainage; the operative note should identify the abscess location and approach.

Select the code based on the documented site and procedure, not simply the diagnosis of anorectal abscess. A superficial perianal collection or a transanal drainage approach points to a different code; when fistula surgery accompanies drainage, consider the code that includes that work. Medicare treats this as major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing 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 South Carolina compares for 46040

Across 109 of 109 payment localities, the office rate for 46040 runs from $552.30 in Arkansas to $814.44 in San Benito County, CA. South Carolina pays $592.71. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

46040 rates by state

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

See 46040 in every payment locality

How the 46040 rate is calculated

Each of 46040’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 46040

46040 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 46040

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

How 46040 has changed in South Carolina

Price 46040 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

• Abbeville
• Abney Crossroads
• Adams Run
• Aiken
• Alcolu
• Allendale
• Anderson
• Andrews

Browse all communities in South Carolina

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