Billing code 45020: Abscess drainageMedicare rate & RVUs in Delaware
Reports operative drainage of a perirectal abscess through a transperineal approach, with the documented abscess location and surgical route distinguishing it from rectal or superficial perianal drainage.
CMS doesn’t publish an office rate for 45020 in Delaware.
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 9 sections
What 45020 covers
This operation drains a perirectal abscess by reaching the collection through the perineum. A colorectal or general surgeon typically performs it in an operating room when the abscess location and required approach call for operative drainage. The operative report should identify the abscess location, the transperineal route, and the drainage performed; a superficial perianal collection or a submucosal rectal abscess points to a different procedure.
Report the service based on the documented anatomy and approach, not simply the presence of an abscess. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. When other 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. Medicare does not pay an assistant at surgery; 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.
45020 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $545.06 |
How the 45020 rate is calculated
Each of 45020’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 · 45020
RVUs × geographic indexes × conversion factor
Work8.35
8.35 RVUs× 1.000 GPCI
Practice expense6.54
6.54 RVUs× 1.000 GPCI
Malpractice1.63
1.63 RVUs× 1.000 GPCI
Adjusted RVUs
16.5200
Conversion factor
$33.4009
Medicare rate
$551.78
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45020
45020 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45020
Abscess drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 1 | Not paid (statutory restriction). |
| 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) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 45020
Abscess drainage
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
45020 without 51 · national facility
$551.78
Abscess drainage
45020-51 · Second procedure: 50%
$275.89
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%).
45020 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 45000Pelvic abscess drainage
- Choose 45000 for a pelvic abscess drained transrectally. Code 45020 describes perirectal abscess drainage through the perineum.
- 45005Rectal abscess drainage
- 45005 is for a submucosal rectal abscess approached transanally; 45020 is for perirectal drainage through a transperineal route.
- 46050Perianal abscess drainage
- 46050 applies to a superficial perianal abscess. 45020 describes operative drainage of a perirectal abscess through the perineum.
- 46040Abscess drainage
- 46040 is used for drainage of an ischiorectal or intramural abscess. For 45020, the operative documentation supports a perirectal abscess and transperineal route.
45020 billing questions
How is 45020 distinguished from 45005?
45020 describes drainage of a perirectal abscess through the perineum. 45005 is for a submucosal rectal abscess approached transanally.
When would 45000 be a better fit?
45000 is for drainage of a pelvic abscess through a transrectal approach. Use the documented abscess location and route to distinguish it from perirectal drainage through the perineum.
Does the 90-day global include postoperative visits?
It includes related postoperative care for 90 days, as well as the preoperative visit on the day before surgery.
Can modifier 50 be reported?
No. The anatomy and descriptor make bilateral adjustment inappropriate for this service.
Can an assistant or co-surgeon be paid for this operation?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full; other procedures performed in that session are subject to the standard 50% 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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