$570.82
Choose 46060 when the abscess operation also treats an associated fistula by fistulotomy or fistulectomy. Choose 46040 for drainage without that fistula treatment.
On this page
CMS RVU26D · Effective 2026-10-01
46060 Abscess drainage Medicare reimbursement rates in Iowa
Drainage of an ischiorectal or intramural abscess with surgical treatment of an associated fistula, including seton placement when performed. Compare 46060 office and facility rates across CMS payment localities in Iowa.
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.
What does Medicare pay for 46060 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$446.74
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Anorectal surgery
About 46060: Ischiorectal abscess drainage with fistula treatment
Drainage of an ischiorectal or intramural abscess with surgical treatment of an associated fistula, including seton placement when performed.
This operation drains a deep abscess in the ischiorectal space or within the anorectal wall while also treating an associated fistula tract by fistulotomy or fistulectomy. Seton placement is included when performed as part of the operation. A colorectal or general surgeon typically performs the procedure in an operating room when the abscess and fistula require operative treatment; it is more extensive than draining a superficial perianal collection.
Report 46060 when the operative service includes both abscess drainage and fistula treatment. The operative report should identify the abscess location, the fistula tract and the work performed on it, and whether a seton was placed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 46060
- 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 RVU6.21 · 42%
- Practice expense (office) RVU7.31 · 50%
- Malpractice RVU1.20 · 8%
581
Medicare services in 2024 · #3426 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.
46060 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
46045 describes transanal abscess drainage under anesthesia. 46060 is the combined ischiorectal or intramural abscess and fistula operation.
$243.78
46050 is for a superficial perianal abscess. 46060 involves a deeper ischiorectal or intramural abscess with fistula treatment.
No office rate
46020 is for seton placement alone; 46060 includes seton placement when performed during the combined abscess drainage and fistula treatment.
Compare 46060 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
Unavailable
Facility
$446.74
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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 46060 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
5,575
- Code
- 46060
- Physician work
- 6.21
- Practice expense
- 7.31
- Malpractice
- 1.20
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.21 | × 1.000 | 6.2100 |
| Practice expense | 7.31 | × 0.915 | 6.6886 |
| Malpractice | 1.20 | × 0.397 | 0.4764 |
| Total RVUs | 13.3750 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$446.74
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.21 | 1 |
| Practice expense | 7.31 | 0.915 |
| Malpractice | 1.2 | 0.397 |
(6.21 × 1 + 7.31 × 0.915 + 1.2 × 0.397) × $33.4009 = $446.74
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.
46060 billing questions
How is 46060 different from 46040?
46060 includes surgical treatment of an associated fistula along with abscess drainage. Use 46040 for ischiorectal or perirectal abscess drainage without the fistulotomy or fistulectomy service.
Is seton placement separately reported with 46060?
Seton placement is included when performed as part of the 46060 operation. For seton placement without the combined abscess-drainage and fistula-treatment service, consider 46020.
What documentation supports 46060?
Document the abscess location, the associated fistula tract, and the drainage and fistula work performed. Note seton placement if performed.
Can modifier 50 be used for bilateral disease?
No. The CMS bilateral adjustment does not apply to 46060, and modifier 50 is inappropriate for this code.
How does the global period affect follow-up billing?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. Unrelated services are not described by that inclusion.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 46060. 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.
5,57246040,,I&d ischiorct&/perirct absc,A,,5.24,12.43,,6.58,,1.20,18.87,13.02,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,57346045,,I&d absc tranal under anes,A,,5.72,6.43,NA,6.43,,1.25,13.40,13.40,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,57446050,,I&d perianal abscess supfc,A,,1.21,6.55,,1.65,,0.24,8.00,3.10,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,57546060,,I&d ischiorectal/ntrmrl absc,A,,6.21,7.31,NA,7.31,,1.20,14.72,14.72,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,57646070,,Incision anal septum infant,A,,2.72,5.23,NA,5.23,,0.72,8.67,8.67,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,57746080,,Sphnctrotmy anal div sphnctr,A,,2.46,6.50,,1.54,,0.49,9.45,4.49,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,57846083,,Inc thrombosed hroid xtrnl,A,,1.41,5.06,,1.53,,0.28,6.75,3.22,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136