CPT code 46275: Fistula surgery, intersphincteric tract2026 Medicare rate & RVUs in Redding, CA

Report 46275 for operative treatment of an anal fistula that runs between the internal and external sphincters, based on documented tract anatomy.

CMS RVU26DEffective Oct 1, 2026One payment locality1K Medicare services in 2024

In Redding, CA, Medicare pays $658.88 for 46275 in the office and $433.75 when it’s performed in a hospital or facility.

$658.88Office (non-facility)
$433.75Hospital or facility
+4.5%vs the national office rate ($630.61)

Check a contract rate as a % of Medicare · 46275 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 46275 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Redding, CA
  2. What 46275 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 46275 covers

Code 46275 describes operative treatment of an anal fistula whose tract lies between the internal and external anal sphincters. The surgeon identifies the tract and opens or removes it as appropriate to the documented anatomy. Colorectal and general surgeons commonly perform this procedure in an operating room or ambulatory surgery setting. It is distinct from treatment of a superficial tract beneath the skin and from procedures for complex or staged fistulas.

Report this code when the operative findings and technique support an intersphincteric fistula; do not select it based on the external opening alone. The operative note should identify the tract course, sphincter involvement, treatment performed, and any associated procedure. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and remaining procedures at 50%. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment is statutorily restricted, and 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 Redding, CA compares for 46275

Across 109 of 109 payment localities, the office rate for 46275 runs from $555.30 in Arkansas to $821.13 in San Benito County, CA. Redding, CA pays $658.88. The RVUs are the same everywhere; the geographic indexes change the dollars.

46275 in Redding, CA vs other payment areas
  1. Redding, CA · this page$658.88
  2. Bakersfield, CA · California$661.63+$2.75
  3. Chico, CA · California$658.88
  4. El Centro, CA · California$659.05+$0.17
  5. Fresno, CA · California$658.88
  6. Hanford, CA · California$658.88
  7. Los Angeles, CA · California$703.98+$45.10

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

Every other payment area

46275 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$658.88$433.75
Merced, CACalifornia$658.88$433.75
Modesto, CACalifornia$658.88$433.75
Napa, CACalifornia$759.66$488.92
Oxnard, CACalifornia$699.92$457.12
Rest of CaliforniaCalifornia$658.88$433.75
Riverside, CACalifornia$669.44$444.30
Sacramento, CACalifornia$690.48$451.58

46275 rates by state

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

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.

$555.30

$740.01

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

View every state and territory as a table
46275 office rate range by state
State / territoryOffice rate rangeLocalities
AK$731.491
AL$563.711
AR$555.301
AZ$612.831
CA$658.88–$821.1329
CO$652.531
CT$673.471
DC$718.861
DE$623.131
FL$628.53–$697.943
GA$591.37–$644.462
GU$674.581
HI$674.581
IA$575.041
ID$579.641
IL$612.37–$676.344
IN$583.011
KS$573.911
KY$581.041
LA$580.76–$610.192
MA$649.13–$716.012
MD$634.75–$718.863
ME$584.51–$614.742
MI$598.16–$638.312
MN$619.791
MO$571.59–$610.443
MS$563.471
MT$630.541
NC$590.551
ND$611.171
NE$577.791
NH$643.801
NJ$679.62–$711.392
NM$602.201
NV$625.561
NY$599.81–$749.625
OH$594.201
OK$578.211
OR$619.20–$671.842
PA$594.24–$657.382
PR$634.751
RI$644.331
SC$593.661
SD$608.871
TN$577.101
TX$590.35–$651.688
UT$601.981
VA$613.82–$718.862
VI$634.751
VT$610.221
WA$647.42–$729.122
WI$590.251
WV$589.501
WY$622.101

See 46275 in every payment locality

How the 46275 rate is calculated

Each of 46275’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 · 46275

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.28

5.28 RVUs× 1.000 GPCI

Practice expense12.62

12.62 RVUs× 1.000 GPCI

Malpractice0.98

0.98 RVUs× 1.000 GPCI

Adjusted RVUs

18.8800

Conversion factor

$33.4009

Medicare rate

$630.61

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

The exact Redding, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,591

Code
46275
Physician work
5.28
Practice expense
12.62
Malpractice
0.98

GPCI2026.csv

19

Locality
Redding, CA
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office calculation for 46275 in Redding, CA
ComponentRVULocality factorAdjusted
Physician work5.28× 1.0175.3698
Practice expense12.62× 1.09613.8315
Malpractice0.98× 0.5360.5253
Total RVUs19.7266
Conversion factor× 33.4009

Office rate, Redding, CA$658.88

Office: (5.28 × 1.017 + 12.62 × 1.096 + 0.98 × 0.536) × $33.4009 = $658.88

Facility: (5.28 × 1.017 + 6.47 × 1.096 + 0.98 × 0.536) × $33.4009 = $433.75

Open 46275 in the RVU calculator

Payment rules and modifiers for 46275

46275 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46275

Fistula surgery, intersphincteric tract

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 46275

Fistula surgery, intersphincteric tract

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

46275 without 51 · national office

$630.61

Fistula surgery, intersphincteric tract

46275-51 · Second procedure: 50%

$315.31

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

How 46275 has changed in Redding, CA

46275 · Office / nonfacility

$658.88

Effective 2026-10-01

The base rate is $85.78 higher than on 2025-10-01, moving from $573.10 to $658.88 (15.0%).

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

    $573.10changed to$658.88

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.42 changed to 5.28
    • Practice expense RVU 10.70 changed to 12.62
    • Malpractice RVU 0.94 changed to 0.98
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $587.59changed to$573.10

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 10.63 changed to 10.70
    • Malpractice RVU 0.96 changed to 0.94

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $578.00changed to$587.59

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $594.99changed to$578.00

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.65 changed to 10.63
    • Malpractice RVU 0.92 changed to 0.96
    • Work GPCI 1.021 changed to 1.014
    • Practice expense GPCI 1.079 changed to 1.093
    • Malpractice GPCI 0.579 changed to 0.560
  5. January 1, 2023

    RVU23A

    $605.71changed to$594.99

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.67 changed to 10.65
    • Malpractice RVU 0.96 changed to 0.92
    • Work GPCI 1.027 changed to 1.021
    • Practice expense GPCI 1.065 changed to 1.079
    • Malpractice GPCI 0.597 changed to 0.579

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $604.54changed to$605.71

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.52 changed to 10.67
    • Malpractice RVU 0.93 changed to 0.96

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $587.57changed to$604.54

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.53 changed to 10.52
    • Malpractice RVU 0.92 changed to 0.93
    • Work GPCI 1.024 changed to 1.027
    • Practice expense GPCI 1.070 changed to 1.065
    • Malpractice GPCI 0.580 changed to 0.597

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $576.16changed to$587.57

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 9.22 changed to 9.53
    • Malpractice RVU 0.99 changed to 0.92
    • Work GPCI 1.020 changed to 1.024
    • Practice expense GPCI 1.074 changed to 1.070
    • Malpractice GPCI 0.562 changed to 0.580

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $571.66changed to$576.16

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.12 changed to 9.22

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $569.37changed to$571.66

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.00 changed to 9.12
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.079 changed to 1.074
    • Malpractice GPCI 0.610 changed to 0.562

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$569.37

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$658.88$433.75RVU26D
2026-07-01$658.88$433.75RVU26C
2026-04-01$658.88$433.75RVU26B
2026-01-01$658.88$433.75RVU26A
2025-10-01$573.10$426.37RVU25D
2025-07-01$573.10$426.37RVU25C
2025-04-01$573.10$426.37RVU25B
2025-01-01$573.10$426.37RVU25A
2024-10-01$587.59$434.06RVU24D
2024-07-01$587.59$434.06RVU24C
2024-04-01$587.59$434.06RVU24B
2024-03-09$587.59$434.06RVU24AR
2024-01-01$578.00$426.97RVU24A
2023-10-01$594.99$437.03RVU23D
2023-07-01$594.99$437.03RVU23C
2023-04-01$594.99$437.03RVU23B
2023-01-01$594.99$437.03RVU23A
2022-10-01$605.71$442.07RVU22D
2022-07-01$605.71$442.07RVU22C
2022-04-01$605.71$442.07RVU22B
2022-01-01$605.71$442.07RVU22A
2021-10-01$604.54$439.17RVU21D
2021-07-01$604.54$439.17RVU21C
2021-04-01$604.54$439.17RVU21B
2021-01-01$604.54$439.17RVU21A
2020-10-01$587.57$439.28RVU20D
2020-07-01$587.57$439.28RVU20C
2020-04-01$587.57$439.28RVU20B
2020-01-01$587.57$439.28RVU20A
2019-10-01$576.16$435.27RVU19D
2019-07-01$576.16$435.27RVU19C
2019-04-01$576.16$435.27RVU19B
2019-01-01$576.16$435.27RVU19A
2018-10-01$571.66$433.63RVU18D
2018-07-01$571.66$433.63RVU18C
2018-04-01$571.66$433.63RVU18B
2018-01-01$571.66$433.63RVU18AR1
2017-10-01$569.37$434.23RVU17D
2017-07-01$569.37$434.23RVU17C
2017-04-01$569.37$434.23RVU17B
2017-01-01$569.37$434.23RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 46275 for an earlier date of service

Where the Redding, CA rate applies

Redding, CA is a Medicare payment area, not a city. Our Census mapping connects it to 32 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Redding
  • Anderson
  • Bella Vista
  • Big Bend
  • Burney
  • Cassel
  • Castella
  • Centerville

Browse all communities in California

46275 billing questions

How is 46275 distinguished from 46270?

46275 is for an intersphincteric tract between the anal sphincters. Code 46270 is for a subcutaneous tract, so document the tract’s course and sphincter relationship.

What documentation supports reporting 46275?

The operative report should describe the fistula’s course, its relationship to the sphincters, and the treatment performed. The external opening alone does not establish the intersphincteric anatomy.

Can 46275 be reported with hemorrhoid excision?

When the surgeon also excises an internal or external hemorrhoid group and treats the fistula, compare the combined service with 46258. Other procedures performed in the same session are subject to the standard multiple-procedure payment reduction.

Can modifier 50 be used for 46275?

No. The anatomy is not appropriate for bilateral modifier 50 reporting.

How does the global period affect follow-up visits?

The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.

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 46275PPRRVU2026_Oct_nonQPP.csv, line 5,591 (RVU26D)
Geographic factors for Redding, CAGPCI2026.csv, line 19 (RVU26D)

Open CMS sourceHow we calculate rates

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