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

In Riverside, CA, Medicare pays $669.44 for 46275 in the office and $444.30 when it’s performed in a hospital or facility.

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.

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 Riverside, 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. Riverside, CA pays $669.44. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

46275 rates by state

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

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.

Payment rules and modifiers for 46275

46275 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 46275

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

How 46275 has changed in Riverside, CA

Price 46275 for an earlier date of service

Where the Riverside, CA rate applies

Riverside, CA is a Medicare payment area, not a city. Our Census mapping connects it to 127 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

• Ontario
• Riverside
• San Bernardino
• Adelanto
• Aguanga
• Anza
• Apple Valley
• Baker

Browse all communities in California

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