Billing code 46754: Suture removalMedicare rate & RVUs
Removal of suture material from anal tissue, reported for focused anorectal removal rather than routine removal of superficial wound sutures.
Medicare pays $381.44 for 46754 nationally in the office and $239.82 in a hospital or facility. Local office rates run $336.63–$504.83.
Medicare rate · 46754
Suture removal
Swap in your local Medicare rate.
- Work RVUs
- 2.93
- Total RVUs
- 11.42
- Global days
- 010
National rate · 2026
$381.44
Office setting, before claim adjustments.
See every locality for 46754 → · 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
What 46754 covers
This service removes suture material located in or at the anus, such as material remaining after an anorectal procedure. It is typically performed by a colorectal surgeon or another surgeon with anorectal expertise in a procedural or operative setting. The record should make clear that the work is removal of suture material, not repair of the anal sphincter, a fistula, or another anorectal structure.
Select the code when the documented target is suture material from the anus. Record the anatomic site, the material removed, and the work performed so the service can be distinguished from routine wound-suture removal or a repair. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 46754 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$336.63 to $504.83
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $341.66 | $217.74 |
| Alaska* | $441.59 | $290.77 |
| Arizona | $371.06 | $233.83 |
| Arkansas | $336.63 | $214.98 |
| Atlanta | $388.86 | $244.98 |
| Austin | $395.67 | $245.83 |
| Bakersfield | $403.69 | $248.47 |
| Baltimore/Surr. Cntys | $406.01 | $254.05 |
| Beaumont | $356.18 | $227.31 |
| Brazoria | $376.71 | $236.36 |
| Chicago | $401.64 | $259.31 |
| Chico | $402.47 | $247.25 |
| Colorado | $396.79 | $246.11 |
| Connecticut | $407.10 | $254.57 |
| Dallas | $379.25 | $238.20 |
| Dc + Md/Va Suburbs | $436.29 | $269.46 |
| Delaware | $377.28 | $237.36 |
| Detroit | $381.63 | $244.96 |
| East St. Louis | $374.10 | $243.81 |
| El Centro | $402.54 | $247.32 |
| Fort Lauderdale | $396.28 | $252.82 |
| Fort Worth | $376.74 | $237.10 |
| Fresno | $402.47 | $247.25 |
| Galveston | $377.92 | $237.29 |
| Hanford-Corcoran | $402.47 | $247.25 |
| Hawaii, Guam | $412.46 | $251.44 |
| Houston | $385.61 | $244.98 |
| Idaho | $352.48 | $222.19 |
| Indiana | $354.55 | $223.27 |
| Iowa | $350.07 | $220.49 |
| Kansas | $348.60 | $220.58 |
| Kentucky | $350.33 | $224.43 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $430.06 | $262.53 |
| Madera | $402.47 | $247.25 |
| Manhattan | $439.59 | $275.03 |
| Merced | $402.47 | $247.25 |
| Metropolitan Boston | $436.20 | $267.11 |
| Metropolitan Kansas City | $364.67 | $231.69 |
| Metropolitan Philadelphia | $396.96 | $249.53 |
| Metropolitan St. Louis | $368.53 | $233.71 |
| Miami | $413.94 | $266.51 |
| Minnesota | $379.38 | $233.65 |
| Mississippi | $340.31 | $218.38 |
| Modesto | $402.47 | $247.25 |
| Montana** | $381.41 | $239.79 |
| Napa | $466.42 | $279.76 |
| Nebraska | $351.96 | $221.24 |
| Nevada** | $379.37 | $237.60 |
| New Hampshire | $390.74 | $243.31 |
| New Mexico | $361.89 | $232.02 |
| New Orleans | $367.44 | $234.18 |
| North Carolina | $358.31 | $226.18 |
| North Dakota** | $373.11 | $231.49 |
| Northern Nj | $431.68 | $267.41 |
| Nyc Suburbs/Long Island | $450.67 | $282.28 |
| Ohio | $358.10 | $228.80 |
| Oklahoma | $349.47 | $223.00 |
| Oxnard-Thousand Oaks-Ventura | $427.95 | $260.55 |
| Portland | $409.33 | $251.99 |
| Poughkpsie/N Nyc Suburbs | $414.39 | $259.32 |
| Puerto Rico | $384.19 | $241.02 |
| Queens | $442.96 | $275.56 |
| Redding | $402.47 | $247.25 |
| Rest Of California | $402.47 | $247.25 |
| Rest Of Florida | $376.63 | $241.25 |
| Rest Of Georgia | $355.02 | $228.70 |
| Rest Of Illinois | $365.89 | $236.59 |
| Rest Of Louisiana | $349.85 | $224.52 |
| Rest Of Maine | $354.57 | $224.28 |
| Rest Of Maryland | $384.50 | $241.18 |
| Rest Of Massachusetts | $394.44 | $245.32 |
| Rest Of Michigan | $359.80 | $230.50 |
| Rest Of Missouri | $343.88 | $221.80 |
| Rest Of New Jersey | $411.51 | $256.86 |
| Rest Of New York | $363.79 | $229.26 |
| Rest Of Oregon | $376.19 | $235.14 |
| Rest Of Pennsylvania | $358.56 | $228.56 |
| Rest Of Texas | $366.33 | $231.93 |
| Rest Of Washington | $393.64 | $244.52 |
| Rhode Island | $390.68 | $244.38 |
| Riverside-San Bernardino-Ontario | $407.01 | $251.80 |
| Sacramento-Roseville-Folsom | $422.39 | $257.68 |
| Salinas | $420.82 | $256.68 |
| San Diego-Chula Vista-Carlsbad | $430.78 | $261.40 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $493.66 | $293.98 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $493.18 | $293.50 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $504.83 | $300.62 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $502.88 | $298.67 |
| San Luis Obispo-Paso Robles | $414.06 | $252.75 |
| Santa Cruz-Watsonville | $434.94 | $262.87 |
| Santa Maria-Santa Barbara | $422.41 | $257.29 |
| Santa Rosa-Petaluma | $439.32 | $265.41 |
| Seattle (King Cnty) | $444.95 | $271.18 |
| South Carolina | $358.85 | $227.99 |
| South Dakota** | $372.12 | $230.50 |
| Southern Maine | $373.84 | $233.49 |
| Stockton | $402.47 | $247.25 |
| Suburban Chicago | $400.23 | $254.79 |
| Tennessee | $350.41 | $221.68 |
| Utah | $363.83 | $230.71 |
| Vallejo | $465.73 | $279.07 |
| Vermont | $371.81 | $231.61 |
| Virgin Islands | $384.19 | $241.02 |
| Virginia | $372.73 | $233.52 |
| Visalia | $402.47 | $247.25 |
| West Virginia | $352.17 | $229.11 |
| Wisconsin | $360.41 | $224.74 |
| Wyoming** | $377.79 | $236.17 |
| Yuba City | $402.47 | $247.25 |
46754 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.
$336.63
$453.65
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $441.59 | 1 |
| AL | $341.66 | 1 |
| AR | $336.63 | 1 |
| AZ | $371.06 | 1 |
| CA | $402.47–$504.83 | 29 |
| CO | $396.79 | 1 |
| CT | $407.10 | 1 |
| DC | $436.29 | 1 |
| DE | $377.28 | 1 |
| FL | $376.63–$413.94 | 3 |
| GA | $355.02–$388.86 | 2 |
| GU | $412.46 | 1 |
| HI | $412.46 | 1 |
| IA | $350.07 | 1 |
| ID | $352.48 | 1 |
| IL | $365.89–$401.64 | 4 |
| IN | $354.55 | 1 |
| KS | $348.60 | 1 |
| KY | $350.33 | 1 |
| LA | $349.85–$367.44 | 2 |
| MA | $394.44–$436.20 | 2 |
| MD | $384.50–$436.29 | 3 |
| ME | $354.57–$373.84 | 2 |
| MI | $359.80–$381.63 | 2 |
| MN | $379.38 | 1 |
| MO | $343.88–$368.53 | 3 |
| MS | $340.31 | 1 |
| MT | $381.41 | 1 |
| NC | $358.31 | 1 |
| ND | $373.11 | 1 |
| NE | $351.96 | 1 |
| NH | $390.74 | 1 |
| NJ | $411.51–$431.68 | 2 |
| NM | $361.89 | 1 |
| NV | $379.37 | 1 |
| NY | $363.79–$450.67 | 5 |
| OH | $358.10 | 1 |
| OK | $349.47 | 1 |
| OR | $376.19–$409.33 | 2 |
| PA | $358.56–$396.96 | 2 |
| PR | $384.19 | 1 |
| RI | $390.68 | 1 |
| SC | $358.85 | 1 |
| SD | $372.12 | 1 |
| TN | $350.41 | 1 |
| TX | $356.18–$395.67 | 8 |
| UT | $363.83 | 1 |
| VA | $372.73–$436.29 | 2 |
| VI | $384.19 | 1 |
| VT | $371.81 | 1 |
| WA | $393.64–$444.95 | 2 |
| WI | $360.41 | 1 |
| WV | $352.17 | 1 |
| WY | $377.79 | 1 |
How the 46754 rate is calculated
Each of 46754’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 · 46754
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.93Practice expense 8.07Malpractice 0.42
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 46754
46754 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 46754
Suture removal
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 46754
Suture removal
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
46754 without 51 · national office
$381.44
Suture removal
46754-51 · Second procedure: 50%
$190.72
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%).
46754 compared with similar codes
Compare codes
46754 vs 46030 vs 15853 vs 15854 vs 46750: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 46030Seton removal
- 46030 describes removal of an anal seton. This code is for removal of suture material from the anus, not seton removal.
- 15853Closure removal
- 15853 is for routine suture or staple removal without anesthesia. This code is specific to suture material removed from the anus.
- 15854Suture removal
- 15854 is for routine suture or staple removal requiring anesthesia. Use this code when the documented service is specifically removal of suture material from the anus.
- 46750Anal sphincter repair
- 46750 describes anal sphincter repair. This code describes suture removal and should not be selected when the operative work repairs the sphincter.
46754 billing questions
How is this different from routine wound-suture removal?
This code is for suture removal specifically from the anus. Codes 15853 and 15854 address routine suture or staple removal, depending on whether anesthesia is required.
Should I report this for removal of an anal seton?
No. For removal of an anal seton, consider 46030; this code describes removal of suture material from the anus.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in this procedure's payment.
Can I append modifier 50?
No. Modifier 50 is inappropriate for this service.
When is assistant-at-surgery payment allowed?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard multiple procedure reduction.
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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