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CPT 46707: Fistula repairMedicare rate & RVUs

Reports operative repair of an anorectal fistula by placing a plug in the tract, rather than using glue or cutting open the tract.

CMS RVU26DEffective Oct 1, 2026109 payment localities23 Medicare services in 2024

Medicare pays $513.37 for 46707 nationally in a facility.

Medicare rate · 46707

Fistula repair

Swap in your local Medicare rate.

Work RVUs
6.23
Total RVUs
15.37
Global days
090

National rate · 2026

$513.37

Facility setting, before claim adjustments.

See every locality for 46707 →

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 46707 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 46707 covers

A colorectal or general surgeon uses this repair to treat an anorectal fistula by placing a plug within the fistula tract. The plug approach closes the tract while avoiding a cutting fistulotomy. The procedure is typically performed in an operating facility, where the surgeon can identify the tract and position the plug.

Select this code when the operative report documents placement of a fistula plug, rather than injection of glue or a fistulotomy. Document the tract treated and the material placed; preparing the tract and positioning the plug are steps of the repair, not additional plug repairs. Medicare treats this as major surgery: the day-before preoperative visit and 90 days of related postoperative care are included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate for this anatomy. An assistant surgeon is paid only when medical necessity is documented; 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 46707 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

46707 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$458.08
Alaska*Unavailable$608.76
ArizonaUnavailable$497.64
ArkansasUnavailable$451.25
AtlantaUnavailable$529.14
AustinUnavailable$521.96
BakersfieldUnavailable$519.63
Baltimore/Surr. CntysUnavailable$548.08
BeaumontUnavailable$486.95
BrazoriaUnavailable$500.59

46707 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
46707 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 46707 rate is calculated

Each of 46707’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 · 46707

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.23Practice expense 7.48Malpractice 1.66

15.3700 adjusted RVUs×$33.4009 conversion factor=$513.37

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 46707

46707 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46707

Fistula repair

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)0Not paid without supporting documentation.
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 · 46707

Fistula repair

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

46707 without 51 · national facility

$513.37

Fistula repair

46707-51 · Second procedure: 50%

$256.69

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

46707 compared with similar codes

Compare codes

46707 vs 46706 vs 46270 vs 46275: national Medicare rates

Swap in your local Medicare rate.

  • 46707
    Fistula repair · 6.23 wRVU
    —
  • 46706
    Fistula repair · 2.38 wRVU
    —
  • 46270
    Anal fistula surgery · 4.8 wRVU
    $599.88
  • 46275
    Fistula surgery · 5.28 wRVU
    $630.61

How to choose

46706Fistula repair
Both address an anorectal fistula without describing a cutting fistulotomy. Choose 46707 for a plug placed in the tract and 46706 for glue.
46270Anal fistula surgery
Code 46270 describes surgical opening or removal of a subcutaneous anal fistula tract. Choose 46707 when the documented repair uses a plug.
46275Fistula surgery
Code 46275 describes surgical opening or removal of an intersphincteric anal fistula tract. Code 46707 identifies repair by plug placement rather than that cutting approach.

Codes related to 46707

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

Codes related to 46707
CodeHow it relatesNational office range
Used instead
46706Fistula repairAnorectal fistula repair using glue instead of a plug.No office rate
46270Anal fistula surgeryCutting surgical treatment of a subcutaneous anal fistula instead of plug placement.$526.53–$781.84
46275Fistula surgeryCutting surgical treatment of an intersphincteric anal fistula instead of plug placement.$555.30–$821.13

46707 billing questions

When is 46707 reported instead of 46706?

Report 46707 when the surgeon places a plug in the anorectal fistula tract. Code 46706 describes repair using glue instead.

Is tract preparation separately reported from plug placement?

Preparing the fistula tract and positioning the plug are part of the plug repair. The operative report should establish that a plug was placed.

What postoperative care is included?

The code has a 90-day global period. The day-before preoperative visit and 90 days of related postoperative care are included.

How does Medicare pay this repair when another procedure is performed in the same session?

The standard multiple-procedure reduction applies: the highest-valued procedure is paid in full and other procedures at 50%.

Should modifier 50 be used for two fistula tracts?

No. The bilateral adjustment does not apply to this anorectal repair, and modifier 50 is inappropriate.

Can another surgeon assist with the plug repair?

An assistant at surgery is paid only with documentation of medical necessity. Medicare does not permit co-surgeons or team surgery for this code.

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 46707PPRRVU2026_Oct_nonQPP.csv, line 5,612 (RVU26D)

Open CMS sourceHow we calculate rates

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