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CMS RVU26D · Effective 2026-10-01

46285 in Salinas

Office / nonfacility

$688.09

Base rate per service

Facility setting

$451.56

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 46285: Staged anal fistula surgery with seton

Report staged surgical treatment of an anal fistula with seton placement when the operative plan treats the tract in separate stages rather than definitively at one operation.

A colorectal or general surgeon uses this code for an operative plan that treats an anal fistula in stages, including placement of a seton to maintain drainage between procedures. Staged management may be selected when immediate division of the tract could threaten sphincter function. The procedure is generally performed in an operating room, with the operative report documenting the fistula tract, seton placement, and staged treatment plan.

Report this code for the staged seton procedure, not for a single-stage operation selected by fistula anatomy or for a repair coded by its method. The record should support that treatment is staged and describe the work performed during the encounter. CMS classifies the service as major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is statutorily restricted, and co-surgeon and team-surgery billing are not permitted.

CMS billing rules for 46285

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 RVU5.28 · 28%
  • Practice expense (office) RVU12.62 · 67%
  • Malpractice RVU0.99 · 5%

183

Medicare services in 2024 · #4404 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.

46285 compared with similar codes

Office rates for Salinas, from the same CMS release.

46270

Anal fistula surgery

Subcutaneous tract

$654.14

46270 is for a subcutaneous fistula treatment. Choose 46285 when the procedure is staged and includes seton placement.

46275

Fistula surgery

Intersphincteric tract

$687.91

46275 identifies treatment of an intersphincteric fistula; 46285 identifies staged treatment with a seton.

46280

Anal fistula surgery

Complex sphincter-crossing tract

No office rate

46280 is used for specified complex fistula anatomy. 46285 is distinguished by the staged seton approach.

46288

Anal fistula repair

Advancement flap

No office rate

46288 represents anal fistula repair, while 46285 is for staged treatment with seton placement.

The same code, a different location

How does Salinas compare?

In Bakersfield, the office rate for 46285 is $661.83—$26.26 lower than the $688.09 rate in Salinas. Both use the same code, release and participation basis.

46285 across payment areas

Same release and payment basis · bars start at $0

  1. Salinas · This locality

    $688.09

  2. Bakersfield

    $661.83

    $26.26 lower than Salinas

  3. Chico

    $659.06

    $29.03 lower than Salinas

  4. El Centro

    $659.23

    $28.86 lower than Salinas

  5. Fresno

    $659.06

    $29.03 lower than Salinas

  6. Hanford-Corcoran

    $659.06

    $29.03 lower than Salinas

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

    $704.20

    $16.11 higher than Salinas

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, 46285 ranges from $555.47 in Arkansas to $821.31 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

  • Madera

    California · 46285

    Office

    $659.06

    Facility

    $435.39

    $29.03 lower than Salinas for the office setting.

  • Merced

    California · 46285

    Office

    $659.06

    Facility

    $435.39

    $29.03 lower than Salinas for the office setting.

  • Modesto

    California · 46285

    Office

    $659.06

    Facility

    $435.39

    $29.03 lower than Salinas for the office setting.

  • Napa

    California · 46285

    Office

    $759.83

    Facility

    $490.85

    $71.74 higher than Salinas for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 46285

    Office

    $700.13

    Facility

    $458.91

    $12.04 higher than Salinas for the office setting.

  • Redding

    California · 46285

    Office

    $659.06

    Facility

    $435.39

    $29.03 lower than Salinas for the office setting.

  • Rest Of California

    California · 46285

    Office

    $659.06

    Facility

    $435.39

    $29.03 lower than Salinas for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 46285

    Office

    $669.72

    Facility

    $446.05

    $18.37 lower than Salinas for the office setting.

  • Sacramento-Roseville-Folsom

    California · 46285

    Office

    $690.66

    Facility

    $453.31

    $2.57 higher than Salinas for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 46285

    Office

    $703.71

    Facility

    $459.63

    $15.62 higher than Salinas for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 46285

    Office

    $802.63

    Facility

    $514.88

    $114.54 higher than Salinas for the office setting.

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

    California · 46285

    Office

    $801.51

    Facility

    $513.75

    $113.42 higher than Salinas for the office setting.

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

    California · 46285

    Office

    $821.31

    Facility

    $527.03

    $133.22 higher than Salinas for the office setting.

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

    California · 46285

    Office

    $816.71

    Facility

    $522.43

    $128.62 higher than Salinas for the office setting.

  • San Luis Obispo-Paso Robles

    California · 46285

    Office

    $677.19

    Facility

    $444.74

    $10.90 lower than Salinas for the office setting.

  • Santa Cruz-Watsonville

    California · 46285

    Office

    $709.93

    Facility

    $461.97

    $21.84 higher than Salinas for the office setting.

  • Santa Maria-Santa Barbara

    California · 46285

    Office

    $690.51

    Facility

    $452.55

    $2.42 higher than Salinas for the office setting.

  • Santa Rosa-Petaluma

    California · 46285

    Office

    $717.00

    Facility

    $466.39

    $28.91 higher than Salinas for the office setting.

  • Stockton

    California · 46285

    Office

    $659.06

    Facility

    $435.39

    $29.03 lower than Salinas for the office setting.

  • Vallejo

    California · 46285

    Office

    $758.21

    Facility

    $489.23

    $70.12 higher than Salinas for the office setting.

  • Visalia

    California · 46285

    Office

    $659.06

    Facility

    $435.39

    $29.03 lower than Salinas for the office setting.

  • Yuba City

    California · 46285

    Office

    $659.06

    Facility

    $435.39

    $29.03 lower than Salinas for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 46285

    Office

    $719.23

    Facility

    $478.83

    $31.14 higher than Salinas for the office setting.

  • Miami

    Florida · 46285

    Office

    $698.78

    Facility

    $486.34

    $10.69 higher than Salinas for the office setting.

  • Chicago

    Illinois · 46285

    Office

    $677.11

    Facility

    $472.01

    $10.98 lower than Salinas for the office setting.

  • Manhattan

    New York · 46285

    Office

    $729.89

    Facility

    $492.75

    $41.80 higher than Salinas for the office setting.

  • Alaska*

    Alaska · 46285

    Office

    $731.67

    Facility

    $514.33

    $43.58 higher than Salinas for the office setting.

  • Alabama

    Alabama · 46285

    Office

    $563.90

    Facility

    $385.33

    $124.19 lower than Salinas for the office setting.

  • Arkansas

    Arkansas · 46285

    Office

    $555.47

    Facility

    $380.17

    $132.62 lower than Salinas for the office setting.

  • Arizona

    Arizona · 46285

    Office

    $613.11

    Facility

    $415.36

    $74.98 lower than Salinas for the office setting.

  • Colorado

    Colorado · 46285

    Office

    $652.79

    Facility

    $435.65

    $35.30 lower than Salinas for the office setting.

  • Connecticut

    Connecticut · 46285

    Office

    $673.87

    Facility

    $454.08

    $14.22 lower than Salinas for the office setting.

  • Delaware

    Delaware · 46285

    Office

    $623.43

    Facility

    $421.80

    $64.66 lower than Salinas for the office setting.

  • Fort Lauderdale

    Florida · 46285

    Office

    $663.14

    Facility

    $456.41

    $24.95 lower than Salinas for the office setting.

  • Rest Of Florida

    Florida · 46285

    Office

    $629.03

    Facility

    $433.93

    $59.06 lower than Salinas for the office setting.

  • Atlanta

    Georgia · 46285

    Office

    $644.86

    Facility

    $437.52

    $43.23 lower than Salinas for the office setting.

  • Rest Of Georgia

    Georgia · 46285

    Office

    $591.77

    Facility

    $409.73

    $96.32 lower than Salinas for the office setting.

  • Hawaii, Guam

    Hawaii · 46285

    Office

    $674.77

    Facility

    $442.73

    $13.32 lower than Salinas for the office setting.

  • Iowa

    Iowa · 46285

    Office

    $575.17

    Facility

    $388.44

    $112.92 lower than Salinas for the office setting.

  • Idaho

    Idaho · 46285

    Office

    $579.80

    Facility

    $392.04

    $108.29 lower than Salinas for the office setting.

  • East St. Louis

    Illinois · 46285

    Office

    $630.75

    Facility

    $443.00

    $57.34 lower than Salinas for the office setting.

  • Rest Of Illinois

    Illinois · 46285

    Office

    $612.89

    Facility

    $426.56

    $75.20 lower than Salinas for the office setting.

  • Suburban Chicago

    Illinois · 46285

    Office

    $669.09

    Facility

    $459.50

    $19.00 lower than Salinas for the office setting.

  • Indiana

    Indiana · 46285

    Office

    $583.18

    Facility

    $393.99

    $104.91 lower than Salinas for the office setting.

  • Kansas

    Kansas · 46285

    Office

    $574.08

    Facility

    $389.59

    $114.01 lower than Salinas for the office setting.

  • Kentucky

    Kentucky · 46285

    Office

    $581.34

    Facility

    $399.92

    $106.75 lower than Salinas for the office setting.

  • New Orleans

    Louisiana · 46285

    Office

    $610.57

    Facility

    $418.53

    $77.52 lower than Salinas for the office setting.

  • Rest Of Louisiana

    Louisiana · 46285

    Office

    $581.08

    Facility

    $400.47

    $107.01 lower than Salinas for the office setting.

  • Metropolitan Boston

    Massachusetts · 46285

    Office

    $716.31

    Facility

    $472.64

    $28.22 higher than Salinas for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 46285

    Office

    $649.39

    Facility

    $434.50

    $38.70 lower than Salinas for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 46285

    Office

    $672.37

    Facility

    $453.40

    $15.72 lower than Salinas for the office setting.

  • Rest Of Maryland

    Maryland · 46285

    Office

    $635.05

    Facility

    $428.52

    $53.04 lower than Salinas for the office setting.

  • Rest Of Maine

    Maine · 46285

    Office

    $584.72

    Facility

    $396.97

    $103.37 lower than Salinas for the office setting.

  • Southern Maine

    Maine · 46285

    Office

    $614.95

    Facility

    $412.70

    $73.14 lower than Salinas for the office setting.

  • Detroit

    Michigan · 46285

    Office

    $638.87

    Facility

    $441.94

    $49.22 lower than Salinas for the office setting.

  • Rest Of Michigan

    Michigan · 46285

    Office

    $598.54

    Facility

    $412.21

    $89.55 lower than Salinas for the office setting.

  • Minnesota

    Minnesota · 46285

    Office

    $619.89

    Facility

    $409.89

    $68.20 lower than Salinas for the office setting.

  • Metropolitan Kansas City

    Missouri · 46285

    Office

    $604.47

    Facility

    $412.84

    $83.62 lower than Salinas for the office setting.

  • Metropolitan St. Louis

    Missouri · 46285

    Office

    $610.78

    Facility

    $416.49

    $77.31 lower than Salinas for the office setting.

  • Rest Of Missouri

    Missouri · 46285

    Office

    $571.91

    Facility

    $396.00

    $116.18 lower than Salinas for the office setting.

  • Mississippi

    Mississippi · 46285

    Office

    $563.72

    Facility

    $388.01

    $124.37 lower than Salinas for the office setting.

  • Montana**

    Montana · 46285

    Office

    $630.88

    Facility

    $426.80

    $57.21 lower than Salinas for the office setting.

  • North Carolina

    North Carolina · 46285

    Office

    $590.76

    Facility

    $400.36

    $97.33 lower than Salinas for the office setting.

  • North Dakota**

    North Dakota · 46285

    Office

    $611.30

    Facility

    $407.22

    $76.79 lower than Salinas for the office setting.

  • Nebraska

    Nebraska · 46285

    Office

    $577.92

    Facility

    $389.55

    $110.17 lower than Salinas for the office setting.

  • New Hampshire

    New Hampshire · 46285

    Office

    $644.09

    Facility

    $431.65

    $44.00 lower than Salinas for the office setting.

  • Northern Nj

    New Jersey · 46285

    Office

    $711.75

    Facility

    $475.01

    $23.66 higher than Salinas for the office setting.

  • Rest Of New Jersey

    New Jersey · 46285

    Office

    $679.98

    Facility

    $457.13

    $8.11 lower than Salinas for the office setting.

  • New Mexico

    New Mexico · 46285

    Office

    $602.60

    Facility

    $415.46

    $85.49 lower than Salinas for the office setting.

  • Nevada**

    Nevada · 46285

    Office

    $625.84

    Facility

    $421.56

    $62.25 lower than Salinas for the office setting.

  • Nyc Suburbs/Long Island

    New York · 46285

    Office

    $750.24

    Facility

    $507.58

    $62.15 higher than Salinas for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 46285

    Office

    $685.87

    Facility

    $462.40

    $2.22 lower than Salinas for the office setting.

  • Queens

    New York · 46285

    Office

    $733.56

    Facility

    $492.34

    $45.47 higher than Salinas for the office setting.

  • Rest Of New York

    New York · 46285

    Office

    $600.05

    Facility

    $406.17

    $88.04 lower than Salinas for the office setting.

  • Ohio

    Ohio · 46285

    Office

    $594.54

    Facility

    $408.21

    $93.55 lower than Salinas for the office setting.

  • Oklahoma

    Oklahoma · 46285

    Office

    $578.47

    Facility

    $396.22

    $109.62 lower than Salinas for the office setting.

  • Portland

    Oregon · 46285

    Office

    $672.09

    Facility

    $445.36

    $16.00 lower than Salinas for the office setting.

  • Rest Of Oregon

    Oregon · 46285

    Office

    $619.44

    Facility

    $416.17

    $68.65 lower than Salinas for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 46285

    Office

    $657.78

    Facility

    $445.33

    $30.31 lower than Salinas for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 46285

    Office

    $594.56

    Facility

    $407.21

    $93.53 lower than Salinas for the office setting.

  • Puerto Rico

    Puerto Rico · 46285

    Office

    $635.08

    Facility

    $428.76

    $53.01 lower than Salinas for the office setting.

  • Rhode Island

    Rhode Island · 46285

    Office

    $644.63

    Facility

    $433.82

    $43.46 lower than Salinas for the office setting.

  • South Carolina

    South Carolina · 46285

    Office

    $593.95

    Facility

    $405.38

    $94.14 lower than Salinas for the office setting.

  • South Dakota**

    South Dakota · 46285

    Office

    $608.99

    Facility

    $404.91

    $79.10 lower than Salinas for the office setting.

  • Tennessee

    Tennessee · 46285

    Office

    $577.27

    Facility

    $391.77

    $110.82 lower than Salinas for the office setting.

  • Austin

    Texas · 46285

    Office

    $651.97

    Facility

    $436.06

    $36.12 lower than Salinas for the office setting.

  • Beaumont

    Texas · 46285

    Office

    $590.66

    Facility

    $404.95

    $97.43 lower than Salinas for the office setting.

  • Brazoria

    Texas · 46285

    Office

    $621.29

    Facility

    $419.04

    $66.80 lower than Salinas for the office setting.

  • Dallas

    Texas · 46285

    Office

    $626.15

    Facility

    $422.89

    $61.94 lower than Salinas for the office setting.

  • Fort Worth

    Texas · 46285

    Office

    $622.36

    Facility

    $421.14

    $65.73 lower than Salinas for the office setting.

  • Galveston

    Texas · 46285

    Office

    $623.72

    Facility

    $421.06

    $64.37 lower than Salinas for the office setting.

  • Houston

    Texas · 46285

    Office

    $641.84

    Facility

    $439.19

    $46.25 lower than Salinas for the office setting.

  • Rest Of Texas

    Texas · 46285

    Office

    $606.24

    Facility

    $412.57

    $81.85 lower than Salinas for the office setting.

  • Utah

    Utah · 46285

    Office

    $602.28

    Facility

    $410.44

    $85.81 lower than Salinas for the office setting.

  • Virginia

    Virginia · 46285

    Office

    $614.06

    Facility

    $413.45

    $74.03 lower than Salinas for the office setting.

  • Virgin Islands

    United States Virgin Islands · 46285

    Office

    $635.08

    Facility

    $428.76

    $53.01 lower than Salinas for the office setting.

  • Vermont

    Vermont · 46285

    Office

    $610.39

    Facility

    $408.35

    $77.70 lower than Salinas for the office setting.

  • Rest Of Washington

    Washington · 46285

    Office

    $647.67

    Facility

    $432.78

    $40.42 lower than Salinas for the office setting.

  • Seattle (King Cnty)

    Washington · 46285

    Office

    $729.39

    Facility

    $478.99

    $41.30 higher than Salinas for the office setting.

  • Wisconsin

    Wisconsin · 46285

    Office

    $590.36

    Facility

    $394.85

    $97.73 lower than Salinas for the office setting.

  • West Virginia

    West Virginia · 46285

    Office

    $589.98

    Facility

    $412.63

    $98.11 lower than Salinas for the office setting.

  • Wyoming**

    Wyoming · 46285

    Office

    $622.35

    Facility

    $418.27

    $65.74 lower than Salinas for the office setting.

See how rates vary across the country

46285 · 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.

$555.47

$740.19

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$731.671
AL$563.901
AR$555.471
AZ$613.111
CA$659.06–$821.3129
CO$652.791
CT$673.871
DC$719.231
DE$623.431
FL$629.03–$698.783
GA$591.77–$644.862
GU$674.771
HI$674.771
IA$575.171
ID$579.801
IL$612.89–$677.114
IN$583.181
KS$574.081
KY$581.341
LA$581.08–$610.572
MA$649.39–$716.312
MD$635.05–$719.233
ME$584.72–$614.952
MI$598.54–$638.872
MN$619.891
MO$571.91–$610.783
MS$563.721
MT$630.881
NC$590.761
ND$611.301
NE$577.921
NH$644.091
NJ$679.98–$711.752
NM$602.601
NV$625.841
NY$600.05–$750.245
OH$594.541
OK$578.471
OR$619.44–$672.092
PA$594.56–$657.782
PR$635.081
RI$644.631
SC$593.951
SD$608.991
TN$577.271
TX$590.66–$651.978
UT$602.281
VA$614.06–$719.232
VI$635.081
VT$610.391
WA$647.67–$729.392
WI$590.361
WV$589.981
WY$622.351

Explore 46285 on the national rate map →

Where does this rate apply?

Salinas is a Medicare payment area. Our Census mapping connects it to 30 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 46285 in Salinas, the physician’s office rate is $688.09 and the facility-setting rate is $451.56: a difference of $236.53.

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 46285 in Salinas. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$756.90

$688.09 × 110% = $756.90

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 46285 in Salinas.

PPRRVU2026_Oct_nonQPP.csv

5,593

Code
46285
Physician work
5.28
Practice expense
12.62
Malpractice
0.99

GPCI2026.csv

22

Locality
Salinas
Physician work
1.031
Practice expense
1.159
Malpractice
0.536
Office / nonfacility calculation for 46285 in Salinas
ComponentRVULocality factorAdjusted
Physician work5.28× 1.0315.4437
Practice expense12.62× 1.15914.6266
Malpractice0.99× 0.5360.5306
Total RVUs20.6009
Conversion factor× 33.4009

Office / nonfacility rate, Salinas$688.09

Open 46285 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work5.281.031
Practice expense12.621.159
Malpractice0.990.536

(5.28 × 1.031 + 12.62 × 1.159 + 0.99 × 0.536) × $33.4009 = $688.09

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work5.281.031
Practice expense6.511.159
Malpractice0.990.536

(5.28 × 1.031 + 6.51 × 1.159 + 0.99 × 0.536) × $33.4009 = $451.56

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

46285 · Office / nonfacility

$688.09

Effective 2026-10-01

The base rate is $85.86 higher than on 2025-10-01, moving from $602.23 to $688.09 (14.3%).

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

    $602.23changed to$688.09

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.42 changed to 5.28
    • Practice expense RVU 10.69 changed to 12.62
    • Work GPCI 1.035 changed to 1.031
    • Practice expense GPCI 1.165 changed to 1.159
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $602.23

    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$688.09$451.56RVU26D
2026-07-01$688.09$451.56RVU26C
2026-04-01$688.09$451.56RVU26B
2026-01-01$688.09$451.56RVU26A
2025-10-01$602.23$447.35RVU25D
2025-07-01$602.23$447.35RVU25C
2025-04-01$602.23$447.35RVU25B
2025-01-01$602.23$447.35RVU25A

46285 billing questions

When should I choose 46285 over an anatomy-specific fistula code?

Use 46285 when the operative plan is staged and includes seton placement. Codes 46270, 46275, and 46280 describe treatment selected by fistula anatomy or complexity.

Does 46285 include seton placement?

Yes. Seton placement is part of the staged fistula treatment represented by this code.

What documentation supports 46285?

Document the fistula tract, seton placement, and the plan to treat the fistula in stages. The operative report should identify the work performed during that session.

Can I report modifier 50 for bilateral fistulas?

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

Can an assistant or co-surgeon be billed for 46285?

CMS payment for an assistant at surgery is statutorily restricted. Co-surgeon and team-surgery billing are not permitted for this code.

How does the 90-day global period affect follow-up?

The global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures occur in the same session, the standard multiple-procedure reduction applies.

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 46285PPRRVU2026_Oct_nonQPP.csv, line 5,593 (RVU26D)
Geographic factors for SalinasGPCI2026.csv, line 22 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet