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Billing code 46060: Abscess drainageMedicare rate & RVUs

Drainage of an ischiorectal or intramural abscess with surgical treatment of an associated fistula, including seton placement when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities581 Medicare services in 2024

Medicare pays $491.66 for 46060 nationally in a facility.

Medicare rate · 46060

Abscess drainage

Work RVUs
6.21
Total RVUs
14.72
Global days
090

National rate · 2026

$491.66

Facility setting, before claim adjustments.

See every locality for 46060 →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.

On this page 10 sections
  1. Medicare rate
  2. What 46060 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 46060 covers

This operation drains a deep abscess in the ischiorectal space or within the anorectal wall while also treating an associated fistula tract by fistulotomy or fistulectomy. Seton placement is included when performed as part of the operation. A colorectal or general surgeon typically performs the procedure in an operating room when the abscess and fistula require operative treatment; it is more extensive than draining a superficial perianal collection.

Report 46060 when the operative service includes both abscess drainage and fistula treatment. The operative report should identify the abscess location, the fistula tract and the work performed on it, and whether a seton was placed. Medicare assigns 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 are subject to the standard 50% 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 46060 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

46060 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$443.75
Alaska*Unavailable$593.25
ArizonaUnavailable$478.32
ArkansasUnavailable$437.80
AtlantaUnavailable$504.25
AustinUnavailable$501.67
BakersfieldUnavailable$503.37
Baltimore/Surr. CntysUnavailable$522.30
BeaumontUnavailable$466.84
BrazoriaUnavailable$482.31

46060 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
46060 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 46060 rate is calculated

Each of 46060’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 · 46060

RVUs × geographic indexes × conversion factor

Work6.21

6.21 RVUs× 1.000 GPCI

Practice expense7.31

7.31 RVUs× 1.000 GPCI

Malpractice1.20

1.20 RVUs× 1.000 GPCI

Adjusted RVUs

14.7200

Conversion factor

$33.4009

Medicare rate

$491.66

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

Payment rules and modifiers for 46060

46060 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46060

Abscess drainage

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 · 46060

Abscess drainage

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

46060 without 51 · national facility

$491.66

Abscess drainage

46060-51 · Second procedure: 50%

$245.83

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

46060 compared with similar codes

Compare codes · National

5 codes, side by side

  • 46060

    Abscess drainage6.21 wRVU

    Not priced

  • 46040

    Abscess drainage5.24 wRVU

    $630.27

  • 46045

    Abscess drainage5.72 wRVU

    Not priced

  • 46050

    Perianal abscess drainage1.21 wRVU

    $267.21

  • 46020

    Seton placement1.81 wRVU

    Not priced

How to choose

46040Abscess drainage
Choose 46060 when the abscess operation also treats an associated fistula by fistulotomy or fistulectomy. Choose 46040 for drainage without that fistula treatment.
46045Abscess drainage
46045 describes transanal abscess drainage under anesthesia. 46060 is the combined ischiorectal or intramural abscess and fistula operation.
46050Perianal abscess drainage
46050 is for a superficial perianal abscess. 46060 involves a deeper ischiorectal or intramural abscess with fistula treatment.
46020Seton placement
46020 is for seton placement alone; 46060 includes seton placement when performed during the combined abscess drainage and fistula treatment.

Codes related to 46060

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

Codes related to 46060
CodeHow it relatesNational office range
Used instead
46040Abscess drainageIschiorectal or perirectal abscess drainage without the fistula treatment included in 46060.$552.30–$814.44
46045Abscess drainageTransanal drainage under anesthesia for an abscess approached through the anal canal.No office rate
46050Perianal abscess drainageDrainage for a superficial perianal abscess rather than a deep abscess with fistula treatment.$232.47–$364.63
46020Seton placementSeton placement for anal fistula when the combined abscess and fistula operation is not performed.No office rate

46060 billing questions

How is 46060 different from 46040?

46060 includes surgical treatment of an associated fistula along with abscess drainage. Use 46040 for ischiorectal or perirectal abscess drainage without the fistulotomy or fistulectomy service.

Is seton placement separately reported with 46060?

Seton placement is included when performed as part of the 46060 operation. For seton placement without the combined abscess-drainage and fistula-treatment service, consider 46020.

What documentation supports 46060?

Document the abscess location, the associated fistula tract, and the drainage and fistula work performed. Note seton placement if performed.

Can modifier 50 be used for bilateral disease?

No. The CMS bilateral adjustment does not apply to 46060, and modifier 50 is inappropriate for this code.

How does the global period affect follow-up billing?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. Unrelated services are not described by that inclusion.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 46060. Co-surgeons and team surgery are not permitted.

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 46060PPRRVU2026_Oct_nonQPP.csv, line 5,575 (RVU26D)

Open CMS sourceHow we calculate rates

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