CPT code 46712: Fistula repair2026 Medicare rate & RVUs in Georgia
Reports the double-procedure variant of surgical repair for a perineal-vaginal fistula, typically performed by a colorectal or pediatric surgeon.
CMS doesn’t publish an office rate for 46712 in Georgia.
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 46712 covers
This code describes the double-procedure variant of repair for a fistula involving the perineal and vaginal region. The operation addresses the abnormal communication and restores the affected tissue. Colorectal and pediatric surgeons typically perform this type of repair in an operating room, often for congenital anorectal conditions or other perineal-vaginal fistulas. The operative report should establish the fistula anatomy and describe the work that supports the double-procedure variant.
Report 46712 rather than the single-procedure sibling when the documented operation meets the double-procedure distinction; the number of fistula openings alone does not establish that distinction. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 46712 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $2,153.49 |
| Rest Of Georgia | Unavailable | $2,076.16 |
How the 46712 rate is calculated
Each of 46712’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 · 46712
RVUs × geographic indexes × conversion factor
Work35.54
35.54 RVUs× 1.000 GPCI
Practice expense17.12
17.12 RVUs× 1.000 GPCI
Malpractice9.52
9.52 RVUs× 1.000 GPCI
Adjusted RVUs
62.1800
Conversion factor
$33.4009
Medicare rate
$2,076.87
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 46712
46712 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 46712
Fistula repair
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 46712
Fistula repair
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
46712 without 51 · national facility
$2,076.87
Fistula repair
46712-51 · Second procedure: 50%
$1,038.44
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%).
46712 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 46710Pouch repair
- 46710 is the single-procedure sibling. Use 46712 only when the documented operation supports the double-procedure variant.
- 46715Fistula repair
- 46715 addresses a perforated anorectal fistula; 46712 is for the double-procedure variant of perineal-vaginal fistula repair.
- 46716Anorectal repair
- 46716 describes repair of a perforated anorectal or vestibular fistula, not the perineal-vaginal repair variant reported with 46712.
- 46706Fistula repair
- 46706 identifies anal fistula repair using glue. It is a different repair method and indication from the perineal-vaginal double-procedure repair.
46712 billing questions
How do I distinguish 46712 from 46710?
46712 is the double-procedure variant; 46710 is the single-procedure variant. Select based on the operative work and documentation, not simply the number of fistula openings.
Does the 90-day global period include postoperative visits?
It includes the day-before preoperative visit and 90 days of related postoperative care. Those services are part of the global surgical period.
Should modifier 50 be reported?
No. The CMS bilateral adjustment does not apply to 46712, and modifier 50 is inappropriate for this code.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
What should the operative report document?
Document the fistula anatomy and operative work supporting the double-procedure variant. The report should make clear why the operation is not the single-procedure variant.
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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