No office rate
Choose 45000 for a pelvic abscess drained transrectally. Code 45020 describes perirectal abscess drainage through the perineum.
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CMS RVU26D · Effective 2026-10-01
45020 Abscess drainage Medicare reimbursement rates in Maine
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. Compare 45020 office and facility rates across CMS payment localities in Maine.
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 45020 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$513.73–$529.73
2 of 2 localities have a supported rate.
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.
Colorectal surgery
About 45020: Transperineal perirectal abscess drainage
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.
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.
CMS billing rules for 45020
- 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 RVU8.35 · 51%
- Practice expense (office) RVU6.54 · 40%
- Malpractice RVU1.63 · 10%
134
Medicare services in 2024 · #4646 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.
45020 compared with similar codes
Office rates for Maine, from the same CMS release.
$337.59–$357.90
45005 is for a submucosal rectal abscess approached transanally; 45020 is for perirectal drainage through a transperineal route.
$246.67–$262.28
46050 applies to a superficial perianal abscess. 45020 describes operative drainage of a perirectal abscess through the perineum.
$581.91–$611.75
46040 is used for drainage of an ischiorectal or intramural abscess. For 45020, the operative documentation supports a perirectal abscess and transperineal route.
Compare 45020 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$513.73
Southern Maine →
Office / nonfacility
Unavailable
Facility
$529.73
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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 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.
5,45945000,,Drainage of pelvic abscess,A,,6.14,5.09,NA,5.09,,1.13,12.36,12.36,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,46045005,,Drainage of rectal abscess,A,,1.97,8.50,,2.72,,0.51,10.98,5.20,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,4614500F,,Ref to outpt card rehab prog,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,46245020,,Drainage of rectal abscess,A,,8.35,6.54,NA,6.54,,1.63,16.52,16.52,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,46345100,,Biopsy of rectum,A,,3.94,4.33,NA,4.33,,0.78,9.05,9.05,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,46445108,,Anorectal myomectomy,A,,4.99,4.84,NA,4.84,,1.33,11.16,11.16,0,090,0.09,0.81,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,4654510F,,Prev cardrehab qualcardevent,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00