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CPT code 46706: Fistula repair, glue technique2026 Medicare rate & RVUs

Reports operative closure of an anal fistula using glue, typically selected when the surgeon treats the tract with a sealant rather than a plug.

CMS RVU26DEffective Oct 1, 2026109 payment localities14 Medicare services in 2024

Medicare pays $178.03 for 46706 nationally in a facility.

Medicare rate · 46706

Fistula repair, glue technique

Office or facility?

Work RVUs
2.38
Total RVUs
5.33
Global days
010

National rate · 2026

$178.03

Facility setting, before claim adjustments.

See every locality for 46706 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 46706 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 46706 covers

A colorectal or general surgeon uses this procedure to close an anal fistula by preparing the tract and instilling glue as a sealant. It is performed in an operative setting for a patient with a fistulous tract connecting the anal canal and perianal skin. The glue technique aims to close the tract without using a plug or performing a sphincter-cutting fistulotomy.

Report the code when the operative note supports treatment of the anal fistula with glue; document the tract treated and the sealant technique. This code has a 10-day global period, so related postoperative visits during that period are 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 for this code. Medicare does not pay an assistant at surgery, 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.

Where 46706 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

46706 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$159.31
AlaskaUnavailable$213.53
ArizonaUnavailable$172.63
ArkansasUnavailable$157.01
Atlanta, GAUnavailable$183.67
Austin, TXUnavailable$180.34
Bakersfield, CAUnavailable$178.91
Baltimore area, MDUnavailable$189.89
Beaumont, TXUnavailable$169.55
Brazoria, TXUnavailable$173.41

46706 rates by state

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

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Local rates. Clear comparisons.

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

View every state and territory as a table
46706 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 46706 rate is calculated

Each of 46706’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 · 46706

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.38

2.38 RVUs× 1.000 GPCI

Practice expense2.33

2.33 RVUs× 1.000 GPCI

Malpractice0.62

0.62 RVUs× 1.000 GPCI

Adjusted RVUs

5.3300

Conversion factor

$33.4009

Medicare rate

$178.03

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

Payment rules and modifiers for 46706

46706 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46706

Fistula repair, glue technique

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 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)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 46706

Fistula repair, glue technique

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

46706 without 51 · national facility

$178.03

Fistula repair, glue technique

46706-51 · Second procedure: 50%

$89.02

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

46706 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 46706

    Fistula repair, glue technique2.38 wRVU

    Not priced

  • 46707

    Fistula repair, anorectal tract, plug6.23 wRVU

    Not priced

  • 46275

    Fistula surgery, intersphincteric tract5.28 wRVU

    $630.61

  • 46280

    Anal fistula surgery, complex sphincter-crossing tract6.23 wRVU

    Not priced

How to choose

46707Fistula repairAnorectal tract, plug
Choose 46706 for glue-based closure and 46707 for repair using a plug. The documented method distinguishes the two.
46275Fistula surgeryIntersphincteric tract
46275 is for surgical treatment of an intersphincteric anal fistula. Use 46706 when the surgeon's repair method is glue.
46280Anal fistula surgeryComplex sphincter-crossing tract
46280 applies to surgical treatment of specified complex fistula anatomy, including transsphincteric and more extensive tracts. 46706 identifies repair with glue.

Codes related to 46706

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

Codes related to 46706
CodeHow it relatesNational office range
Used instead
46707Fistula repair, anorectal tract, plugAnal fistula repair using a plug rather than glue.No office rate
46275Fistula surgery, intersphincteric tractSurgical treatment of an intersphincteric anal fistula by a different approach.$555.30–$821.13
46280Anal fistula surgery, complex sphincter-crossing tractSurgical treatment of more complex anal fistula anatomy by a different approach.No office rate

46706 billing questions

How is this different from 46707?

46706 describes repair using glue; 46707 is the anal fistula repair code for a plug. The operative technique documented determines which code fits.

Can a fistulotomy be reported instead?

A fistulotomy code describes a different operative approach. Use 46706 when the surgeon repairs the tract with glue, rather than laying open the tract.

Are related postoperative visits separately billable?

Related postoperative visits during the 10-day global period are included in this procedure's payment.

Can modifier 50 or an assistant-at-surgery claim be used?

Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this procedure.

What should the operative note support?

Document the anal fistula treated and that glue was used to close the tract. The note should distinguish the glue technique from plug placement or fistulotomy.

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 46706PPRRVU2026_Oct_nonQPP.csv, line 5,611 (RVU26D)

Open CMS sourceHow we calculate rates

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