CPT code 46706: Fistula repair, glue technique2026 Medicare rate & RVUs in Vermont
Reports operative closure of an anal fistula using glue, typically selected when the surgeon treats the tract with a sealant rather than a plug.
In Vermont, Medicare pays $167.02 for 46706 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 46706 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Vermont compares for 46706
Across 109 of 109 payment localities, the facility rate for 46706 runs from $157.01 in Arkansas to $215.57 in NYC suburbs and Long Island, NY. Vermont pays $167.02. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Vermont · this page$167.02
- Los Angeles, CA · California$188.57+$21.55
- Washington, DC area · District of Columbia$198.51+$31.49
- Miami, FL · Florida$212.88+$45.86
- Chicago, IL · Illinois$205.79+$38.77
- Manhattan, NY · New York$207.86+$40.84
- Alaska · Alaska$213.53+$46.51
Other areas in Vermont first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $159.31 |
| ArkansasArkansas | — | $157.01 |
| ArizonaArizona | — | $172.63 |
| Bakersfield, CACalifornia | — | $178.91 |
| Chico, CACalifornia | — | $177.24 |
| El Centro, CACalifornia | — | $177.34 |
| Fresno, CACalifornia | — | $177.24 |
| Hanford, CACalifornia | — | $177.24 |
| Madera, CACalifornia | — | $177.24 |
| Merced, CACalifornia | — | $177.24 |
| Modesto, CACalifornia | — | $177.24 |
| Napa, CACalifornia | — | $197.59 |
| Oxnard, CACalifornia | — | $186.61 |
| Redding, CACalifornia | — | $177.24 |
| Rest of CaliforniaCalifornia | — | $177.24 |
| Riverside, CACalifornia | — | $183.88 |
| Sacramento, CACalifornia | — | $183.97 |
| Salinas, CACalifornia | — | $183.26 |
| San Diego, CACalifornia | — | $186.18 |
| Marin County, CACalifornia | — | $206.28 |
| San Francisco, CACalifornia | — | $205.58 |
| San Benito County, CACalifornia | — | $211.56 |
| Santa Clara County, CACalifornia | — | $208.68 |
| San Luis Obispo, CACalifornia | — | $180.59 |
| Santa Cruz, CACalifornia | — | $186.82 |
| Santa Maria, CACalifornia | — | $183.56 |
| Santa Rosa, CACalifornia | — | $188.55 |
| Stockton, CACalifornia | — | $177.24 |
| Vallejo, CACalifornia | — | $196.58 |
| Visalia, CACalifornia | — | $177.24 |
| Yuba City, CACalifornia | — | $177.24 |
| ColoradoColorado | — | $179.43 |
| ConnecticutConnecticut | — | $189.96 |
| DelawareDelaware | — | $175.40 |
| Fort Lauderdale, FLFlorida | — | $195.77 |
| Rest of FloridaFlorida | — | $185.02 |
| Atlanta, GAGeorgia | — | $183.67 |
| Rest of GeorgiaGeorgia | — | $173.60 |
| Hawaii, Guam, HIHawaii | — | $179.97 |
| IowaIowa | — | $158.92 |
| IdahoIdaho | — | $160.89 |
| East St. Louis, ILIllinois | — | $192.80 |
| Rest of IllinoisIllinois | — | $182.92 |
| Suburban Chicago, ILIllinois | — | $196.67 |
| IndianaIndiana | — | $161.70 |
| KansasKansas | — | $160.28 |
| KentuckyKentucky | — | $167.63 |
| New Orleans, LALouisiana | — | $176.25 |
| Rest of LouisianaLouisiana | — | $168.21 |
| Metropolitan Boston, MAMassachusetts | — | $194.11 |
| Rest of MassachusettsMassachusetts | — | $179.22 |
| Baltimore area, MDMaryland | — | $189.89 |
| Rest of MarylandMaryland | — | $178.06 |
| Rest of MaineMaine | — | $163.97 |
| Southern Maine, MEMaine | — | $169.68 |
| Detroit, MIMichigan | — | $189.51 |
| Rest of MichiganMichigan | — | $173.93 |
| MinnesotaMinnesota | — | $165.70 |
| Metropolitan Kansas City, MOMissouri | — | $172.80 |
| Metropolitan St. Louis, MOMissouri | — | $174.33 |
| Rest of MissouriMissouri | — | $166.75 |
| MississippiMississippi | — | $161.80 |
| MontanaMontana | — | $177.99 |
| North CarolinaNorth Carolina | — | $165.34 |
| North DakotaNorth Dakota | — | $165.73 |
| NebraskaNebraska | — | $159.15 |
| New HampshireNew Hampshire | — | $178.63 |
| Northern New JerseyNew Jersey | — | $196.89 |
| Rest of New JerseyNew Jersey | — | $190.38 |
| New MexicoNew Mexico | — | $175.73 |
| NevadaNevada | — | $174.65 |
| NYC suburbs and Long Island, NYNew York | — | $215.57 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $193.35 |
| Queens, NYNew York | — | $206.43 |
| Rest of New YorkNew York | — | $167.99 |
| OhioOhio | — | $171.42 |
| OklahomaOklahoma | — | $165.08 |
| Portland, OROregon | — | $182.64 |
| Rest of OregonOregon | — | $171.57 |
| Metropolitan Philadelphia, PAPennsylvania | — | $186.65 |
| Rest of PennsylvaniaPennsylvania | — | $170.51 |
| Puerto RicoPuerto Rico | — | $178.57 |
| Rhode IslandRhode Island | — | $179.87 |
| South CarolinaSouth Carolina | — | $169.01 |
| South DakotaSouth Dakota | — | $164.28 |
| TennesseeTennessee | — | $161.36 |
| Austin, TXTexas | — | $180.34 |
| Beaumont, TXTexas | — | $169.55 |
| Brazoria, TXTexas | — | $173.41 |
| Dallas, TXTexas | — | $175.49 |
| Fort Worth, TXTexas | — | $174.98 |
| Galveston, TXTexas | — | $174.56 |
| Houston, TXTexas | — | $185.90 |
| Rest of TexasTexas | — | $172.05 |
| UtahUtah | — | $171.25 |
| VirginiaVirginia | — | $170.62 |
| Virgin Islands, VIUnited States Virgin Islands | — | $178.57 |
| Rest of WashingtonWashington | — | $178.24 |
| King County, WAWashington | — | $195.88 |
| WisconsinWisconsin | — | $160.43 |
| West VirginiaWest Virginia | — | $176.76 |
| WyomingWyoming | — | $172.64 |
46706 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.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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.
The exact Vermont inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,611
- Code
- 46706
- Physician work
- 2.38
- Practice expense
- 2.33
- Malpractice
- 0.62
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.38 | × 1.000 | 2.3800 |
| Practice expense | 2.33 | × 0.990 | 2.3067 |
| Malpractice | 0.62 | × 0.506 | 0.3137 |
| Total RVUs | 5.0004 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$167.02
Facility: (2.38 × 1 + 2.33 × 0.99 + 0.62 × 0.506) × $33.4009 = $167.02
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
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%).
How 46706 has changed in Vermont
46706 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $167.02 | RVU26D |
| 2026-07-01 | Not available in this setting | $167.02 | RVU26C |
| 2026-04-01 | Not available in this setting | $167.02 | RVU26B |
| 2026-01-01 | Not available in this setting | $167.02 | RVU26A |
| 2025-10-01 | Not available in this setting | $168.18 | RVU25D |
| 2025-07-01 | Not available in this setting | $168.18 | RVU25C |
| 2025-04-01 | Not available in this setting | $168.18 | RVU25B |
| 2025-01-01 | Not available in this setting | $168.18 | RVU25A |
| 2024-10-01 | Not available in this setting | $170.91 | RVU24D |
| 2024-07-01 | Not available in this setting | $170.91 | RVU24C |
| 2024-04-01 | Not available in this setting | $170.91 | RVU24B |
| 2024-03-09 | Not available in this setting | $170.91 | RVU24AR |
| 2024-01-01 | Not available in this setting | $168.12 | RVU24A |
| 2023-10-01 | Not available in this setting | $172.78 | RVU23D |
| 2023-07-01 | Not available in this setting | $172.78 | RVU23C |
| 2023-04-01 | Not available in this setting | $172.78 | RVU23B |
| 2023-01-01 | Not available in this setting | $172.78 | RVU23A |
| 2022-10-01 | Not available in this setting | $176.12 | RVU22D |
| 2022-07-01 | Not available in this setting | $176.12 | RVU22C |
| 2022-04-01 | Not available in this setting | $176.12 | RVU22B |
| 2022-01-01 | Not available in this setting | $176.12 | RVU22A |
| 2021-10-01 | Not available in this setting | $175.14 | RVU21D |
| 2021-07-01 | Not available in this setting | $175.14 | RVU21C |
| 2021-04-01 | Not available in this setting | $175.14 | RVU21B |
| 2021-01-01 | Not available in this setting | $175.14 | RVU21A |
| 2020-10-01 | Not available in this setting | $177.06 | RVU20D |
| 2020-07-01 | Not available in this setting | $177.06 | RVU20C |
| 2020-04-01 | Not available in this setting | $177.06 | RVU20B |
| 2020-01-01 | Not available in this setting | $177.06 | RVU20A |
| 2019-10-01 | Not available in this setting | $176.31 | RVU19D |
| 2019-07-01 | Not available in this setting | $176.31 | RVU19C |
| 2019-04-01 | Not available in this setting | $176.31 | RVU19B |
| 2019-01-01 | Not available in this setting | $176.31 | RVU19A |
| 2018-10-01 | Not available in this setting | $175.75 | RVU18D |
| 2018-07-01 | Not available in this setting | $175.75 | RVU18C |
| 2018-04-01 | Not available in this setting | $175.75 | RVU18B |
| 2018-01-01 | Not available in this setting | $175.75 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $174.09 | RVU17D |
| 2017-07-01 | Not available in this setting | $174.09 | RVU17C |
| 2017-04-01 | Not available in this setting | $174.09 | RVU17B |
| 2017-01-01 | Not available in this setting | $174.09 | RVU17A |
| 2016-10-01 | Not available in this setting | $167.44 | RVU16D |
| 2016-07-01 | Not available in this setting | $167.44 | RVU16C |
| 2016-04-01 | Not available in this setting | $167.44 | RVU16B |
| 2016-01-01 | Not available in this setting | $167.44 | RVU16A |
| 2015-10-01 | Not available in this setting | $175.85 | RVU15D |
| 2015-07-01 | Not available in this setting | $175.85 | RVU15C |
| 2015-04-01 | Not available in this setting | $174.97 | RVU15B |
| 2015-01-01 | Not available in this setting | $174.97 | RVU15A |
| 2014-10-01 | Not available in this setting | $169.06 | RVU14D |
| 2014-07-01 | Not available in this setting | $169.06 | RVU14C |
| 2014-04-01 | Not available in this setting | $169.06 | RVU14B |
| 2014-01-01 | Not available in this setting | $169.06 | RVU14A |
| 2013-10-01 | Not available in this setting | Rate data unavailable | RVU13D |
| 2013-07-01 | Not available in this setting | Rate data unavailable | RVU13C |
| 2013-04-01 | Not available in this setting | Rate data unavailable | RVU13B |
| 2013-01-01 | Not available in this setting | Rate data unavailable | RVU13AR |
Where the Vermont rate applies
Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.
- Albany
- Alburgh
- Algiers
- Arlington
- Ascutney
- Bakersfield
- Barnet
- Barre
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
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