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CMS RVU26D · Effective 2026-10-01

45020 Abscess drainage Medicare reimbursement rates in Nevada

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 Nevada.

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 Nevada?

Nevada 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

$542.91

1 of 1 localities have a supported rate.

Payment area: Nevada**

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.

Find 45020 in your payment locality →

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 Nevada, from the same CMS release.

45000

Pelvic abscess drainage

Transrectal approach

No office rate

Choose 45000 for a pelvic abscess drained transrectally. Code 45020 describes perirectal abscess drainage through the perineum.

45005

Rectal abscess drainage

Submucosal abscess

$364.18

45005 is for a submucosal rectal abscess approached transanally; 45020 is for perirectal drainage through a transperineal route.

46050

Perianal abscess drainage

Superficial abscess

$266.09

46050 applies to a superficial perianal abscess. 45020 describes operative drainage of a perirectal abscess through the perineum.

46040

Abscess drainage

Ischiorectal or intramural

$624.00

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.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

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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 45020 in Nevada**.

PPRRVU2026_Oct_nonQPP.csv

5,462

Code
45020
Physician work
8.35
Practice expense
6.54
Malpractice
1.63

GPCI2026.csv

73

Locality
Nevada**
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Facility calculation for 45020 in Nevada**
ComponentRVULocality factorAdjusted
Physician work8.35× 1.0008.3500
Practice expense6.54× 1.0016.5465
Malpractice1.63× 0.8331.3578
Total RVUs16.2543
Conversion factor× 33.4009

Facility rate, Nevada**$542.91

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work8.351
Practice expense6.541.001
Malpractice1.630.833

(8.35 × 1 + 6.54 × 1.001 + 1.63 × 0.833) × $33.4009 = $542.91

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.

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.

RVUs for 45020PPRRVU2026_Oct_nonQPP.csv, line 5,462 (RVU26D)
Geographic factors for Nevada**GPCI2026.csv, line 73 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet