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CMS RVU26D · Effective 2026-10-01

46200 in El Centro

Office / nonfacility

$561.33

Base rate per service

Facility setting

$360.73

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.

Anorectal surgery

About 46200: Anal fissure excision with sphincterotomy

Reports operative removal of diseased anal fissure tissue, including sphincterotomy when performed, when the fissure is treated surgically.

The surgeon removes diseased tissue from an anal fissure; sphincterotomy is included when performed as part of the operation. Colorectal and general surgeons typically perform this procedure in an operating room under anesthesia for a fissure requiring surgical treatment. The operative report should identify the fissure and describe the excision and any sphincter work performed.

Select this code when the fissure itself is excised. When hemorrhoidectomy and fissure treatment are performed together, consider the combined hemorrhoidectomy-and-fissure codes 46257 or 46261 according to the hemorrhoid groups treated. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, Medicare pays the highest-valued procedure in full and reduces other procedures to 50%. Modifier 50 is inappropriate for this anatomy. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.

CMS billing rules for 46200

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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 RVU3.50 · 22%
  • Practice expense (office) RVU11.79 · 74%
  • Malpractice RVU0.60 · 4%

818

Medicare services in 2024 · #3126 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.

46200 compared with similar codes

Office rates for El Centro, from the same CMS release.

46257

Hemorrhoidectomy

One group with fissurectomy

No office rate

Use this combined code when fissure treatment accompanies hemorrhoidectomy for one internal or external hemorrhoid group; 46200 describes fissure excision without that combined service.

46261

Hemorrhoidectomy

Multiple groups with fissurectomy

No office rate

This combined code describes fissure treatment with hemorrhoidectomy for two or more groups. Choose 46200 when the operative service is fissure excision without that hemorrhoidectomy.

46220

Anal tag excision

Single external tag

$292.49

This code targets an anal papilla, not the fissure. Choose 46200 when the surgeon excises diseased fissure tissue.

46230

Anal tag excision

Multiple tags

$359.60

This code targets anal tags. It is not a substitute for fissure excision when the operative target is the fissure.

The same code, a different location

How does El Centro compare?

In Bakersfield, the office rate for 46200 is $562.93—$1.60 higher than the $561.33 rate in El Centro. Both use the same code, release and participation basis.

46200 across payment areas

Same release and payment basis · bars start at $0

  1. El Centro · This locality

    $561.33

  2. Bakersfield

    $562.93

    $1.60 higher than El Centro

  3. Chico

    $561.23

    $0.10 lower than El Centro

  4. Fresno

    $561.23

    $0.10 lower than El Centro

  5. Hanford-Corcoran

    $561.23

    $0.10 lower than El Centro

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

    $600.86

    $39.53 higher than El Centro

  7. Madera

    $561.23

    $0.10 lower than El Centro

Other payment areas listed in California 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, 46200 ranges from $465.50 in Arkansas to $708.36 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

  • Merced

    California · 46200

    Office

    $561.23

    Facility

    $360.62

    $0.10 lower than El Centro for the office setting.

  • Modesto

    California · 46200

    Office

    $561.23

    Facility

    $360.62

    $0.10 lower than El Centro for the office setting.

  • Napa

    California · 46200

    Office

    $653.47

    Facility

    $412.23

    $92.14 higher than El Centro for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 46200

    Office

    $598.13

    Facility

    $381.78

    $36.80 higher than El Centro for the office setting.

  • Redding

    California · 46200

    Office

    $561.23

    Facility

    $360.62

    $0.10 lower than El Centro for the office setting.

  • Rest Of California

    California · 46200

    Office

    $561.23

    Facility

    $360.62

    $0.10 lower than El Centro for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 46200

    Office

    $567.70

    Facility

    $367.09

    $6.37 higher than El Centro for the office setting.

  • Sacramento-Roseville-Folsom

    California · 46200

    Office

    $589.84

    Facility

    $376.97

    $28.51 higher than El Centro for the office setting.

  • Salinas

    California · 46200

    Office

    $587.68

    Facility

    $375.54

    $26.35 higher than El Centro for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 46200

    Office

    $602.25

    Facility

    $383.34

    $40.92 higher than El Centro for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 46200

    Office

    $692.46

    Facility

    $434.38

    $131.13 higher than El Centro for the office setting.

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

    California · 46200

    Office

    $691.78

    Facility

    $433.70

    $130.45 higher than El Centro for the office setting.

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

    California · 46200

    Office

    $708.36

    Facility

    $444.42

    $147.03 higher than El Centro for the office setting.

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

    California · 46200

    Office

    $705.57

    Facility

    $441.63

    $144.24 higher than El Centro for the office setting.

  • San Luis Obispo-Paso Robles

    California · 46200

    Office

    $578.17

    Facility

    $369.69

    $16.84 higher than El Centro for the office setting.

  • Santa Cruz-Watsonville

    California · 46200

    Office

    $608.56

    Facility

    $386.17

    $47.23 higher than El Centro for the office setting.

  • Santa Maria-Santa Barbara

    California · 46200

    Office

    $590.09

    Facility

    $376.66

    $28.76 higher than El Centro for the office setting.

  • Santa Rosa-Petaluma

    California · 46200

    Office

    $614.73

    Facility

    $389.96

    $53.40 higher than El Centro for the office setting.

  • Stockton

    California · 46200

    Office

    $561.23

    Facility

    $360.62

    $0.10 lower than El Centro for the office setting.

  • Vallejo

    California · 46200

    Office

    $652.49

    Facility

    $411.25

    $91.16 higher than El Centro for the office setting.

  • Visalia

    California · 46200

    Office

    $561.23

    Facility

    $360.62

    $0.10 lower than El Centro for the office setting.

  • Yuba City

    California · 46200

    Office

    $561.23

    Facility

    $360.62

    $0.10 lower than El Centro for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 46200

    Office

    $609.41

    Facility

    $393.80

    $48.08 higher than El Centro for the office setting.

  • Miami

    Florida · 46200

    Office

    $577.53

    Facility

    $386.99

    $16.20 higher than El Centro for the office setting.

  • Chicago

    Illinois · 46200

    Office

    $559.48

    Facility

    $375.53

    $1.85 lower than El Centro for the office setting.

  • Manhattan

    New York · 46200

    Office

    $613.76

    Facility

    $401.07

    $52.43 higher than El Centro for the office setting.

  • Alaska*

    Alaska · 46200

    Office

    $605.79

    Facility

    $410.86

    $44.46 higher than El Centro for the office setting.

  • Alabama

    Alabama · 46200

    Office

    $472.82

    Facility

    $312.66

    $88.51 lower than El Centro for the office setting.

  • Arkansas

    Arkansas · 46200

    Office

    $465.50

    Facility

    $308.27

    $95.83 lower than El Centro for the office setting.

  • Arizona

    Arizona · 46200

    Office

    $515.65

    Facility

    $338.28

    $45.68 lower than El Centro for the office setting.

  • Colorado

    Colorado · 46200

    Office

    $552.96

    Facility

    $358.21

    $8.37 lower than El Centro for the office setting.

  • Connecticut

    Connecticut · 46200

    Office

    $567.61

    Facility

    $370.48

    $6.28 higher than El Centro for the office setting.

  • Delaware

    Delaware · 46200

    Office

    $524.58

    Facility

    $343.73

    $36.75 lower than El Centro for the office setting.

  • Fort Lauderdale

    Florida · 46200

    Office

    $552.05

    Facility

    $366.64

    $9.28 lower than El Centro for the office setting.

  • Rest Of Florida

    Florida · 46200

    Office

    $523.49

    Facility

    $348.51

    $37.84 lower than El Centro for the office setting.

  • Atlanta

    Georgia · 46200

    Office

    $541.42

    Facility

    $355.45

    $19.91 lower than El Centro for the office setting.

  • Rest Of Georgia

    Georgia · 46200

    Office

    $492.06

    Facility

    $328.79

    $69.27 lower than El Centro for the office setting.

  • Hawaii, Guam

    Hawaii · 46200

    Office

    $576.25

    Facility

    $368.14

    $14.92 higher than El Centro for the office setting.

  • Iowa

    Iowa · 46200

    Office

    $485.18

    Facility

    $317.70

    $76.15 lower than El Centro for the office setting.

  • Idaho

    Idaho · 46200

    Office

    $488.68

    Facility

    $320.28

    $72.65 lower than El Centro for the office setting.

  • East St. Louis

    Illinois · 46200

    Office

    $519.56

    Facility

    $351.16

    $41.77 lower than El Centro for the office setting.

  • Rest Of Illinois

    Illinois · 46200

    Office

    $507.76

    Facility

    $340.65

    $53.57 lower than El Centro for the office setting.

  • Suburban Chicago

    Illinois · 46200

    Office

    $557.66

    Facility

    $369.68

    $3.67 lower than El Centro for the office setting.

  • Indiana

    Indiana · 46200

    Office

    $491.69

    Facility

    $322.02

    $69.64 lower than El Centro for the office setting.

  • Kansas

    Kansas · 46200

    Office

    $483.00

    Facility

    $317.53

    $78.33 lower than El Centro for the office setting.

  • Kentucky

    Kentucky · 46200

    Office

    $485.33

    Facility

    $322.61

    $76.00 lower than El Centro for the office setting.

  • New Orleans

    Louisiana · 46200

    Office

    $510.23

    Facility

    $337.99

    $51.10 lower than El Centro for the office setting.

  • Rest Of Louisiana

    Louisiana · 46200

    Office

    $484.61

    Facility

    $322.62

    $76.72 lower than El Centro for the office setting.

  • Metropolitan Boston

    Massachusetts · 46200

    Office

    $609.73

    Facility

    $391.18

    $48.40 higher than El Centro for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 46200

    Office

    $549.41

    Facility

    $356.68

    $11.92 lower than El Centro for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 46200

    Office

    $566.11

    Facility

    $369.71

    $4.78 higher than El Centro for the office setting.

  • Rest Of Maryland

    Maryland · 46200

    Office

    $534.99

    Facility

    $349.76

    $26.34 lower than El Centro for the office setting.

  • Rest Of Maine

    Maine · 46200

    Office

    $491.66

    Facility

    $323.27

    $69.67 lower than El Centro for the office setting.

  • Southern Maine

    Maine · 46200

    Office

    $519.80

    Facility

    $338.41

    $41.53 lower than El Centro for the office setting.

  • Detroit

    Michigan · 46200

    Office

    $530.71

    Facility

    $354.07

    $30.62 lower than El Centro for the office setting.

  • Rest Of Michigan

    Michigan · 46200

    Office

    $499.07

    Facility

    $331.95

    $62.26 lower than El Centro for the office setting.

  • Minnesota

    Minnesota · 46200

    Office

    $528.05

    Facility

    $339.71

    $33.28 lower than El Centro for the office setting.

  • Metropolitan Kansas City

    Missouri · 46200

    Office

    $506.26

    Facility

    $334.39

    $55.07 lower than El Centro for the office setting.

  • Metropolitan St. Louis

    Missouri · 46200

    Office

    $511.88

    Facility

    $337.63

    $49.45 lower than El Centro for the office setting.

  • Rest Of Missouri

    Missouri · 46200

    Office

    $475.88

    Facility

    $318.10

    $85.45 lower than El Centro for the office setting.

  • Mississippi

    Mississippi · 46200

    Office

    $470.77

    Facility

    $313.18

    $90.56 lower than El Centro for the office setting.

  • Montana**

    Montana · 46200

    Office

    $530.70

    Facility

    $347.66

    $30.63 lower than El Centro for the office setting.

  • North Carolina

    North Carolina · 46200

    Office

    $497.12

    Facility

    $326.35

    $64.21 lower than El Centro for the office setting.

  • North Dakota**

    North Dakota · 46200

    Office

    $518.84

    Facility

    $335.80

    $42.49 lower than El Centro for the office setting.

  • Nebraska

    Nebraska · 46200

    Office

    $487.95

    Facility

    $319.01

    $73.38 lower than El Centro for the office setting.

  • New Hampshire

    New Hampshire · 46200

    Office

    $544.38

    Facility

    $353.84

    $16.95 lower than El Centro for the office setting.

  • Northern Nj

    New Jersey · 46200

    Office

    $602.48

    Facility

    $390.15

    $41.15 higher than El Centro for the office setting.

  • Rest Of New Jersey

    New Jersey · 46200

    Office

    $573.59

    Facility

    $373.71

    $12.26 higher than El Centro for the office setting.

  • New Mexico

    New Mexico · 46200

    Office

    $502.08

    Facility

    $334.24

    $59.25 lower than El Centro for the office setting.

  • Nevada**

    Nevada · 46200

    Office

    $527.79

    Facility

    $344.57

    $33.54 lower than El Centro for the office setting.

  • Nyc Suburbs/Long Island

    New York · 46200

    Office

    $629.82

    Facility

    $412.19

    $68.49 higher than El Centro for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 46200

    Office

    $577.62

    Facility

    $377.19

    $16.29 higher than El Centro for the office setting.

  • Queens

    New York · 46200

    Office

    $618.75

    Facility

    $402.40

    $57.42 higher than El Centro for the office setting.

  • Rest Of New York

    New York · 46200

    Office

    $505.10

    Facility

    $331.21

    $56.23 lower than El Centro for the office setting.

  • Ohio

    Ohio · 46200

    Office

    $496.64

    Facility

    $329.53

    $64.69 lower than El Centro for the office setting.

  • Oklahoma

    Oklahoma · 46200

    Office

    $484.14

    Facility

    $320.68

    $77.19 lower than El Centro for the office setting.

  • Portland

    Oregon · 46200

    Office

    $571.19

    Facility

    $367.84

    $9.86 higher than El Centro for the office setting.

  • Rest Of Oregon

    Oregon · 46200

    Office

    $523.21

    Facility

    $340.91

    $38.12 lower than El Centro for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 46200

    Office

    $552.86

    Facility

    $362.32

    $8.47 lower than El Centro for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 46200

    Office

    $497.35

    Facility

    $329.32

    $63.98 lower than El Centro for the office setting.

  • Puerto Rico

    Puerto Rico · 46200

    Office

    $534.77

    Facility

    $349.72

    $26.56 lower than El Centro for the office setting.

  • Rhode Island

    Rhode Island · 46200

    Office

    $543.79

    Facility

    $354.72

    $17.54 lower than El Centro for the office setting.

  • South Carolina

    South Carolina · 46200

    Office

    $497.81

    Facility

    $328.68

    $63.52 lower than El Centro for the office setting.

  • South Dakota**

    South Dakota · 46200

    Office

    $517.43

    Facility

    $334.40

    $43.90 lower than El Centro for the office setting.

  • Tennessee

    Tennessee · 46200

    Office

    $485.63

    Facility

    $319.25

    $75.70 lower than El Centro for the office setting.

  • Austin

    Texas · 46200

    Office

    $551.53

    Facility

    $357.88

    $9.80 lower than El Centro for the office setting.

  • Beaumont

    Texas · 46200

    Office

    $493.88

    Facility

    $327.31

    $67.45 lower than El Centro for the office setting.

  • Brazoria

    Texas · 46200

    Office

    $523.72

    Facility

    $342.33

    $37.61 lower than El Centro for the office setting.

  • Dallas

    Texas · 46200

    Office

    $527.37

    Facility

    $345.07

    $33.96 lower than El Centro for the office setting.

  • Fort Worth

    Texas · 46200

    Office

    $523.69

    Facility

    $343.22

    $37.64 lower than El Centro for the office setting.

  • Galveston

    Texas · 46200

    Office

    $525.47

    Facility

    $343.72

    $35.86 lower than El Centro for the office setting.

  • Houston

    Texas · 46200

    Office

    $536.45

    Facility

    $354.70

    $24.88 lower than El Centro for the office setting.

  • Rest Of Texas

    Texas · 46200

    Office

    $508.71

    Facility

    $335.01

    $52.62 lower than El Centro for the office setting.

  • Utah

    Utah · 46200

    Office

    $505.07

    Facility

    $333.01

    $56.26 lower than El Centro for the office setting.

  • Virginia

    Virginia · 46200

    Office

    $518.15

    Facility

    $338.23

    $43.18 lower than El Centro for the office setting.

  • Virgin Islands

    United States Virgin Islands · 46200

    Office

    $534.77

    Facility

    $349.72

    $26.56 lower than El Centro for the office setting.

  • Vermont

    Vermont · 46200

    Office

    $516.90

    Facility

    $335.70

    $44.43 lower than El Centro for the office setting.

  • Rest Of Washington

    Washington · 46200

    Office

    $548.34

    Facility

    $355.60

    $12.99 lower than El Centro for the office setting.

  • Seattle (King Cnty)

    Washington · 46200

    Office

    $622.31

    Facility

    $397.72

    $60.98 higher than El Centro for the office setting.

  • Wisconsin

    Wisconsin · 46200

    Office

    $500.33

    Facility

    $324.98

    $61.00 lower than El Centro for the office setting.

  • West Virginia

    West Virginia · 46200

    Office

    $487.79

    Facility

    $328.73

    $73.54 lower than El Centro for the office setting.

  • Wyoming**

    Wyoming · 46200

    Office

    $525.53

    Facility

    $342.49

    $35.80 lower than El Centro for the office setting.

See how rates vary across the country

46200 · 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.

$465.50

$634.80

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$605.791
AL$472.821
AR$465.501
AZ$515.651
CA$561.23–$708.3629
CO$552.961
CT$567.611
DC$609.411
DE$524.581
FL$523.49–$577.533
GA$492.06–$541.422
GU$576.251
HI$576.251
IA$485.181
ID$488.681
IL$507.76–$559.484
IN$491.691
KS$483.001
KY$485.331
LA$484.61–$510.232
MA$549.41–$609.732
MD$534.99–$609.413
ME$491.66–$519.802
MI$499.07–$530.712
MN$528.051
MO$475.88–$511.883
MS$470.771
MT$530.701
NC$497.121
ND$518.841
NE$487.951
NH$544.381
NJ$573.59–$602.482
NM$502.081
NV$527.791
NY$505.10–$629.825
OH$496.641
OK$484.141
OR$523.21–$571.192
PA$497.35–$552.862
PR$534.771
RI$543.791
SC$497.811
SD$517.431
TN$485.631
TX$493.88–$551.538
UT$505.071
VA$518.15–$609.412
VI$534.771
VT$516.901
WA$548.34–$622.312
WI$500.331
WV$487.791
WY$525.531

Explore 46200 on the national rate map →

Where does this rate apply?

El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, 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 California →

Why are the office and facility amounts different?

For 46200 in El Centro, the physician’s office rate is $561.33 and the facility-setting rate is $360.73: a difference of $200.60.

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 46200 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$617.46

$561.33 × 110% = $617.46

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 46200 in El Centro.

PPRRVU2026_Oct_nonQPP.csv

5,579

Code
46200
Physician work
3.50
Practice expense
11.79
Malpractice
0.60

GPCI2026.csv

10

Locality
El Centro
Physician work
1.017
Practice expense
1.096
Malpractice
0.541
Office / nonfacility calculation for 46200 in El Centro
ComponentRVULocality factorAdjusted
Physician work3.50× 1.0173.5595
Practice expense11.79× 1.09612.9218
Malpractice0.60× 0.5410.3246
Total RVUs16.8059
Conversion factor× 33.4009

Office / nonfacility rate, El Centro$561.33

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

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Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.51.017
Practice expense11.791.096
Malpractice0.60.541

(3.5 × 1.017 + 11.79 × 1.096 + 0.6 × 0.541) × $33.4009 = $561.33

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.51.017
Practice expense6.311.096
Malpractice0.60.541

(3.5 × 1.017 + 6.31 × 1.096 + 0.6 × 0.541) × $33.4009 = $360.73

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

46200 · Office / nonfacility

$561.33

Effective 2026-10-01

The base rate is $73.31 higher than on 2025-10-01, moving from $488.02 to $561.33 (15.0%).

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

    $488.02changed to$561.33

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.59 changed to 3.50
    • Practice expense RVU 10.16 changed to 11.79
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.570 changed to 0.541

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $488.02

    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$561.33$360.73RVU26D
2026-07-01$561.33$360.73RVU26C
2026-04-01$561.33$360.73RVU26B
2026-01-01$561.33$360.73RVU26A
2025-10-01$488.02$346.95RVU25D
2025-07-01$488.02$346.95RVU25C
2025-04-01$488.02$346.95RVU25B
2025-01-01$488.02$346.95RVU25A

46200 billing questions

When should 46200 be reported instead of 46257 or 46261?

Report 46200 when the operation excises the fissure without the qualifying hemorrhoidectomy described by a combined code. Codes 46257 and 46261 combine fissure treatment with hemorrhoidectomy for the specified hemorrhoid groups.

Is sphincterotomy separately reported with 46200?

Sphincterotomy performed as part of the fissure operation is included in 46200. The operative report should document the work performed.

Does modifier 50 apply to 46200?

No. The anal anatomy and service are not reported bilaterally, so modifier 50 is inappropriate.

How does the 90-day global period affect postoperative visits?

The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those included services are not separately reported as routine postoperative visits.

What happens when another procedure is performed in the same session?

Medicare pays the highest-valued procedure in full and reduces the other procedure or procedures to 50%. An assistant at surgery is not paid, 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 46200PPRRVU2026_Oct_nonQPP.csv, line 5,579 (RVU26D)
Geographic factors for El CentroGPCI2026.csv, line 10 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet