FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

46505 in Delaware

Office / nonfacility

$338.71

Base rate per service

Facility setting

$243.67

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Colorectal procedure

About 46505: Anal sphincter chemodenervation injection

Reports injection to relax an anal sphincter muscle, commonly using botulinum toxin to treat a chronic anal fissure or sphincter spasm.

This procedure delivers a chemical agent, commonly botulinum toxin, into an anal sphincter muscle to reduce muscle activity. Colorectal surgeons and other clinicians experienced in anorectal procedures use it most often for chronic anal fissure when sphincter relaxation is part of treatment. It may be performed in an office or facility, depending on the patient and procedural setting.

Report the injection service, not the toxin itself. Documentation should identify the indication, injected muscle, agent and dose, and injection details. When the practice supplies a separately reportable toxin, report its drug code and units in addition to the procedure as supported by the record. CMS assigns 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. CMS rules also restrict assistant-at-surgery payment and do not permit co-surgeons or team surgery.

CMS billing rules for 46505

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU3.10 · 30%
  • Practice expense (office) RVU6.61 · 64%
  • Malpractice RVU0.55 · 5%

1.6K

Medicare services in 2024 · #2636 by national volume

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.

46505 compared with similar codes

Office rates for Delaware, from the same CMS release.

46500

Hemorrhoid injection

Sclerosing treatment

$353.92

This code targets an anal sphincter muscle for chemodenervation. Code 46500 describes injection treatment directed at hemorrhoids.

46200

Fissure surgery

Fissure excision

$524.58

Use this code for chemical relaxation of an anal sphincter muscle. Code 46200 describes operative fissure treatment rather than an injection.

46600

Diagnostic anoscopy

Standard visualization, optional washing

$127.45

Anoscopy examines the anal canal with a scope; it does not describe injection of a chemical agent into an anal sphincter muscle.

The same code, a different location

How does Delaware compare?

46505 across payment areas

Same release and payment basis · bars start at $0

  1. Delaware · This locality

    $338.71

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $381.17

    $42.46 higher than Delaware

  3. Dc + Md/Va Suburbs

    $389.66

    $50.95 higher than Delaware

  4. Miami

    $379.83

    $41.12 higher than Delaware

  5. Chicago

    $368.31

    $29.60 higher than Delaware

  6. Manhattan

    $395.85

    $57.14 higher than Delaware

  7. Alaska*

    $400.57

    $61.86 higher than Delaware

Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 46505 ranges from $302.65 in Arkansas to $443.14 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Alabama

    Alabama · 46505

    Office

    $307.12

    Facility

    $222.95

    $31.59 lower than Delaware for the office setting.

  • Arkansas

    Arkansas · 46505

    Office

    $302.65

    Facility

    $220.02

    $36.06 lower than Delaware for the office setting.

  • Arizona

    Arizona · 46505

    Office

    $333.20

    Facility

    $239.99

    $5.51 lower than Delaware for the office setting.

  • Bakersfield

    California · 46505

    Office

    $358.67

    Facility

    $253.24

    $19.96 higher than Delaware for the office setting.

  • Chico

    California · 46505

    Office

    $357.12

    Facility

    $251.70

    $18.41 higher than Delaware for the office setting.

  • El Centro

    California · 46505

    Office

    $357.22

    Facility

    $251.79

    $18.51 higher than Delaware for the office setting.

  • Fresno

    California · 46505

    Office

    $357.12

    Facility

    $251.70

    $18.41 higher than Delaware for the office setting.

  • Hanford-Corcoran

    California · 46505

    Office

    $357.12

    Facility

    $251.70

    $18.41 higher than Delaware for the office setting.

  • Madera

    California · 46505

    Office

    $357.12

    Facility

    $251.70

    $18.41 higher than Delaware for the office setting.

  • Merced

    California · 46505

    Office

    $357.12

    Facility

    $251.70

    $18.41 higher than Delaware for the office setting.

  • Modesto

    California · 46505

    Office

    $357.12

    Facility

    $251.70

    $18.41 higher than Delaware for the office setting.

  • Napa

    California · 46505

    Office

    $410.39

    Facility

    $283.60

    $71.68 higher than Delaware for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 46505

    Office

    $378.85

    Facility

    $265.15

    $40.14 higher than Delaware for the office setting.

  • Redding

    California · 46505

    Office

    $357.12

    Facility

    $251.70

    $18.41 higher than Delaware for the office setting.

  • Rest Of California

    California · 46505

    Office

    $357.12

    Facility

    $251.70

    $18.41 higher than Delaware for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 46505

    Office

    $363.05

    Facility

    $257.62

    $24.34 higher than Delaware for the office setting.

  • Sacramento-Roseville-Folsom

    California · 46505

    Office

    $373.88

    Facility

    $262.01

    $35.17 higher than Delaware for the office setting.

  • Salinas

    California · 46505

    Office

    $372.48

    Facility

    $260.99

    $33.77 higher than Delaware for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 46505

    Office

    $380.66

    Facility

    $265.61

    $41.95 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 46505

    Office

    $433.11

    Facility

    $297.48

    $94.40 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 46505

    Office

    $432.49

    Facility

    $296.85

    $93.78 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 46505

    Office

    $443.14

    Facility

    $304.43

    $104.43 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 46505

    Office

    $440.59

    Facility

    $301.88

    $101.88 higher than Delaware for the office setting.

  • San Luis Obispo-Paso Robles

    California · 46505

    Office

    $366.62

    Facility

    $257.05

    $27.91 higher than Delaware for the office setting.

  • Santa Cruz-Watsonville

    California · 46505

    Office

    $383.81

    Facility

    $266.93

    $45.10 higher than Delaware for the office setting.

  • Santa Maria-Santa Barbara

    California · 46505

    Office

    $373.72

    Facility

    $261.56

    $35.01 higher than Delaware for the office setting.

  • Santa Rosa-Petaluma

    California · 46505

    Office

    $387.61

    Facility

    $269.49

    $48.90 higher than Delaware for the office setting.

  • Stockton

    California · 46505

    Office

    $357.12

    Facility

    $251.70

    $18.41 higher than Delaware for the office setting.

  • Vallejo

    California · 46505

    Office

    $409.49

    Facility

    $282.70

    $70.78 higher than Delaware for the office setting.

  • Visalia

    California · 46505

    Office

    $357.12

    Facility

    $251.70

    $18.41 higher than Delaware for the office setting.

  • Yuba City

    California · 46505

    Office

    $357.12

    Facility

    $251.70

    $18.41 higher than Delaware for the office setting.

  • Colorado

    Colorado · 46505

    Office

    $354.04

    Facility

    $251.69

    $15.33 higher than Delaware for the office setting.

  • Connecticut

    Connecticut · 46505

    Office

    $365.62

    Facility

    $262.02

    $26.91 higher than Delaware for the office setting.

  • Fort Lauderdale

    Florida · 46505

    Office

    $360.41

    Facility

    $262.96

    $21.70 higher than Delaware for the office setting.

  • Rest Of Florida

    Florida · 46505

    Office

    $342.22

    Facility

    $250.26

    $3.51 higher than Delaware for the office setting.

  • Atlanta

    Georgia · 46505

    Office

    $350.23

    Facility

    $252.50

    $11.52 higher than Delaware for the office setting.

  • Rest Of Georgia

    Georgia · 46505

    Office

    $322.38

    Facility

    $236.57

    $16.33 lower than Delaware for the office setting.

  • Hawaii, Guam

    Hawaii · 46505

    Office

    $365.21

    Facility

    $255.83

    $26.50 higher than Delaware for the office setting.

  • Iowa

    Iowa · 46505

    Office

    $312.85

    Facility

    $224.83

    $25.86 lower than Delaware for the office setting.

  • Idaho

    Idaho · 46505

    Office

    $315.35

    Facility

    $226.85

    $23.36 lower than Delaware for the office setting.

  • East St. Louis

    Illinois · 46505

    Office

    $343.66

    Facility

    $255.16

    $4.95 higher than Delaware for the office setting.

  • Rest Of Illinois

    Illinois · 46505

    Office

    $333.83

    Facility

    $246.00

    $4.88 lower than Delaware for the office setting.

  • Suburban Chicago

    Illinois · 46505

    Office

    $363.56

    Facility

    $264.77

    $24.85 higher than Delaware for the office setting.

  • Indiana

    Indiana · 46505

    Office

    $317.13

    Facility

    $227.96

    $21.58 lower than Delaware for the office setting.

  • Kansas

    Kansas · 46505

    Office

    $312.39

    Facility

    $225.43

    $26.32 lower than Delaware for the office setting.

  • Kentucky

    Kentucky · 46505

    Office

    $316.63

    Facility

    $231.11

    $22.08 lower than Delaware for the office setting.

  • New Orleans

    Louisiana · 46505

    Office

    $332.17

    Facility

    $241.65

    $6.54 lower than Delaware for the office setting.

  • Rest Of Louisiana

    Louisiana · 46505

    Office

    $316.53

    Facility

    $231.40

    $22.18 lower than Delaware for the office setting.

  • Metropolitan Boston

    Massachusetts · 46505

    Office

    $387.75

    Facility

    $272.89

    $49.04 higher than Delaware for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 46505

    Office

    $352.32

    Facility

    $251.03

    $13.61 higher than Delaware for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 46505

    Office

    $364.82

    Facility

    $261.60

    $26.11 higher than Delaware for the office setting.

  • Rest Of Maryland

    Maryland · 46505

    Office

    $344.87

    Facility

    $247.52

    $6.16 higher than Delaware for the office setting.

  • Rest Of Maine

    Maine · 46505

    Office

    $318.09

    Facility

    $229.59

    $20.62 lower than Delaware for the office setting.

  • Southern Maine

    Maine · 46505

    Office

    $333.93

    Facility

    $238.60

    $4.78 lower than Delaware for the office setting.

  • Detroit

    Michigan · 46505

    Office

    $347.57

    Facility

    $254.74

    $8.86 higher than Delaware for the office setting.

  • Rest Of Michigan

    Michigan · 46505

    Office

    $325.86

    Facility

    $238.03

    $12.85 lower than Delaware for the office setting.

  • Minnesota

    Minnesota · 46505

    Office

    $336.16

    Facility

    $237.18

    $2.55 lower than Delaware for the office setting.

  • Metropolitan Kansas City

    Missouri · 46505

    Office

    $328.80

    Facility

    $238.48

    $9.91 lower than Delaware for the office setting.

  • Metropolitan St. Louis

    Missouri · 46505

    Office

    $332.13

    Facility

    $240.56

    $6.58 lower than Delaware for the office setting.

  • Rest Of Missouri

    Missouri · 46505

    Office

    $311.75

    Facility

    $228.83

    $26.96 lower than Delaware for the office setting.

  • Mississippi

    Mississippi · 46505

    Office

    $307.21

    Facility

    $224.39

    $31.50 lower than Delaware for the office setting.

  • Montana**

    Montana · 46505

    Office

    $342.66

    Facility

    $246.46

    $3.95 higher than Delaware for the office setting.

  • North Carolina

    North Carolina · 46505

    Office

    $321.27

    Facility

    $231.52

    $17.44 lower than Delaware for the office setting.

  • North Dakota**

    North Dakota · 46505

    Office

    $331.78

    Facility

    $235.59

    $6.93 lower than Delaware for the office setting.

  • Nebraska

    Nebraska · 46505

    Office

    $314.27

    Facility

    $225.48

    $24.44 lower than Delaware for the office setting.

  • New Hampshire

    New Hampshire · 46505

    Office

    $349.45

    Facility

    $249.31

    $10.74 higher than Delaware for the office setting.

  • Northern Nj

    New Jersey · 46505

    Office

    $385.79

    Facility

    $274.20

    $47.08 higher than Delaware for the office setting.

  • Rest Of New Jersey

    New Jersey · 46505

    Office

    $368.93

    Facility

    $263.88

    $30.22 higher than Delaware for the office setting.

  • New Mexico

    New Mexico · 46505

    Office

    $328.06

    Facility

    $239.85

    $10.65 lower than Delaware for the office setting.

  • Nevada**

    Nevada · 46505

    Office

    $339.85

    Facility

    $243.56

    $1.14 higher than Delaware for the office setting.

  • Nyc Suburbs/Long Island

    New York · 46505

    Office

    $406.79

    Facility

    $292.42

    $68.08 higher than Delaware for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 46505

    Office

    $372.18

    Facility

    $266.85

    $33.47 higher than Delaware for the office setting.

  • Queens

    New York · 46505

    Office

    $397.62

    Facility

    $283.92

    $58.91 higher than Delaware for the office setting.

  • Rest Of New York

    New York · 46505

    Office

    $326.20

    Facility

    $234.81

    $12.51 lower than Delaware for the office setting.

  • Ohio

    Ohio · 46505

    Office

    $323.63

    Facility

    $235.81

    $15.08 lower than Delaware for the office setting.

  • Oklahoma

    Oklahoma · 46505

    Office

    $314.97

    Facility

    $229.07

    $23.74 lower than Delaware for the office setting.

  • Portland

    Oregon · 46505

    Office

    $364.15

    Facility

    $257.28

    $25.44 higher than Delaware for the office setting.

  • Rest Of Oregon

    Oregon · 46505

    Office

    $336.35

    Facility

    $240.54

    $2.36 lower than Delaware for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 46505

    Office

    $357.15

    Facility

    $257.02

    $18.44 higher than Delaware for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 46505

    Office

    $323.58

    Facility

    $235.27

    $15.13 lower than Delaware for the office setting.

  • Puerto Rico

    Puerto Rico · 46505

    Office

    $344.85

    Facility

    $247.59

    $6.14 higher than Delaware for the office setting.

  • Rhode Island

    Rhode Island · 46505

    Office

    $349.96

    Facility

    $250.59

    $11.25 higher than Delaware for the office setting.

  • South Carolina

    South Carolina · 46505

    Office

    $323.16

    Facility

    $234.27

    $15.55 lower than Delaware for the office setting.

  • South Dakota**

    South Dakota · 46505

    Office

    $330.50

    Facility

    $234.30

    $8.21 lower than Delaware for the office setting.

  • Tennessee

    Tennessee · 46505

    Office

    $314.10

    Facility

    $226.66

    $24.61 lower than Delaware for the office setting.

  • Austin

    Texas · 46505

    Office

    $353.61

    Facility

    $251.84

    $14.90 higher than Delaware for the office setting.

  • Beaumont

    Texas · 46505

    Office

    $321.52

    Facility

    $233.98

    $17.19 lower than Delaware for the office setting.

  • Brazoria

    Texas · 46505

    Office

    $337.49

    Facility

    $242.16

    $1.22 lower than Delaware for the office setting.

  • Dallas

    Texas · 46505

    Office

    $340.13

    Facility

    $244.32

    $1.42 higher than Delaware for the office setting.

  • Fort Worth

    Texas · 46505

    Office

    $338.16

    Facility

    $243.32

    $0.55 lower than Delaware for the office setting.

  • Galveston

    Texas · 46505

    Office

    $338.82

    Facility

    $243.30

    $0.11 higher than Delaware for the office setting.

  • Houston

    Texas · 46505

    Office

    $348.88

    Facility

    $253.36

    $10.17 higher than Delaware for the office setting.

  • Rest Of Texas

    Texas · 46505

    Office

    $329.65

    Facility

    $238.36

    $9.06 lower than Delaware for the office setting.

  • Utah

    Utah · 46505

    Office

    $327.57

    Facility

    $237.15

    $11.14 lower than Delaware for the office setting.

  • Virginia

    Virginia · 46505

    Office

    $333.54

    Facility

    $238.98

    $5.17 lower than Delaware for the office setting.

  • Virgin Islands

    United States Virgin Islands · 46505

    Office

    $344.85

    Facility

    $247.59

    $6.14 higher than Delaware for the office setting.

  • Vermont

    Vermont · 46505

    Office

    $331.41

    Facility

    $236.18

    $7.30 lower than Delaware for the office setting.

  • Rest Of Washington

    Washington · 46505

    Office

    $351.35

    Facility

    $250.06

    $12.64 higher than Delaware for the office setting.

  • Seattle (King Cnty)

    Washington · 46505

    Office

    $394.63

    Facility

    $276.59

    $55.92 higher than Delaware for the office setting.

  • Wisconsin

    Wisconsin · 46505

    Office

    $320.71

    Facility

    $228.55

    $18.00 lower than Delaware for the office setting.

  • West Virginia

    West Virginia · 46505

    Office

    $321.69

    Facility

    $238.10

    $17.02 lower than Delaware for the office setting.

  • Wyoming**

    Wyoming · 46505

    Office

    $337.92

    Facility

    $241.72

    $0.79 lower than Delaware for the office setting.

See how rates vary across the country

46505 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$302.65

$400.57

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$400.571
AL$307.121
AR$302.651
AZ$333.201
CA$357.12–$443.1429
CO$354.041
CT$365.621
DC$389.661
DE$338.711
FL$342.22–$379.833
GA$322.38–$350.232
GU$365.211
HI$365.211
IA$312.851
ID$315.351
IL$333.83–$368.314
IN$317.131
KS$312.391
KY$316.631
LA$316.53–$332.172
MA$352.32–$387.752
MD$344.87–$389.663
ME$318.09–$333.932
MI$325.86–$347.572
MN$336.161
MO$311.75–$332.133
MS$307.211
MT$342.661
NC$321.271
ND$331.781
NE$314.271
NH$349.451
NJ$368.93–$385.792
NM$328.061
NV$339.851
NY$326.20–$406.795
OH$323.631
OK$314.971
OR$336.35–$364.152
PA$323.58–$357.152
PR$344.851
RI$349.961
SC$323.161
SD$330.501
TN$314.101
TX$321.52–$353.618
UT$327.571
VA$333.54–$389.662
VI$344.851
VT$331.411
WA$351.35–$394.632
WI$320.711
WV$321.691
WY$337.921

Explore 46505 on the national rate map →

Where does this rate apply?

Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Delaware →

Why are the office and facility amounts different?

For 46505 in Delaware, the physician’s office rate is $338.71 and the facility-setting rate is $243.67: a difference of $95.04.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 46505 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$372.58

$338.71 × 110% = $372.58

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 46505 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

5,597

Code
46505
Physician work
3.10
Practice expense
6.61
Malpractice
0.55

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office / nonfacility calculation for 46505 in Delaware
ComponentRVULocality factorAdjusted
Physician work3.10× 1.0053.1155
Practice expense6.61× 0.9886.5307
Malpractice0.55× 0.8990.4945
Total RVUs10.1406
Conversion factor× 33.4009

Office / nonfacility rate, Delaware$338.71

Open 46505 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.11.005
Practice expense6.610.988
Malpractice0.550.899

(3.1 × 1.005 + 6.61 × 0.988 + 0.55 × 0.899) × $33.4009 = $338.71

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.11.005
Practice expense3.730.988
Malpractice0.550.899

(3.1 × 1.005 + 3.73 × 0.988 + 0.55 × 0.899) × $33.4009 = $243.67

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

46505 · Office / nonfacility

$338.71

Effective 2026-10-01

The base rate is $35.77 higher than on 2025-10-01, moving from $302.94 to $338.71 (11.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $302.94changed to$338.71

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.18 changed to 3.10
    • Practice expense RVU 5.69 changed to 6.61
    • Malpractice RVU 0.54 changed to 0.55
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $302.94

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$338.71$243.67RVU26D
2026-07-01$338.71$243.67RVU26C
2026-04-01$338.71$243.67RVU26B
2026-01-01$338.71$243.67RVU26A
2025-10-01$302.94$242.94RVU25D
2025-07-01$302.94$242.94RVU25C
2025-04-01$302.94$242.94RVU25B
2025-01-01$302.94$242.94RVU25A

46505 billing questions

When is this code appropriate for an anal fissure?

Use it when a chemical agent is injected into an anal sphincter muscle to reduce muscle activity, commonly as treatment for a chronic fissure. A surgical fissure procedure such as 46200 describes a different method.

Is the botulinum toxin included in the procedure code?

The code represents the injection service. When the practice supplies a separately reportable toxin, report the applicable drug code and documented units separately.

Can modifier 50 be used for injections on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; do not append modifier 50.

Are related postoperative visits separately reported?

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

How does CMS handle other procedures performed in the same session?

The highest-valued procedure is paid in full, while other procedures in that session are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment is restricted, and 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 46505PPRRVU2026_Oct_nonQPP.csv, line 5,597 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet