No office rate
46710 is the single-procedure sibling. Use 46712 only when the documented operation supports the double-procedure variant.
On this page
CMS RVU26D · Effective 2026-10-01
46712 Fistula repair Medicare reimbursement rates in Rhode Island
Reports the double-procedure variant of surgical repair for a perineal-vaginal fistula, typically performed by a colorectal or pediatric surgeon. Compare 46712 office and facility rates across CMS payment localities in Rhode Island.
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 46712 in Rhode Island?
Rhode Island 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
$2083.95
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Colorectal surgery
About 46712: Perineal-vaginal fistula repair, double procedure
Reports the double-procedure variant of surgical repair for a perineal-vaginal fistula, typically performed by a colorectal or pediatric surgeon.
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.
CMS billing rules for 46712
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU35.54 · 57%
- Practice expense (office) RVU17.12 · 28%
- Malpractice RVU9.52 · 15%
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.
46712 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
46715 addresses a perforated anorectal fistula; 46712 is for the double-procedure variant of perineal-vaginal fistula repair.
No office rate
46716 describes repair of a perforated anorectal or vestibular fistula, not the perineal-vaginal repair variant reported with 46712.
No office rate
46706 identifies anal fistula repair using glue. It is a different repair method and indication from the perineal-vaginal double-procedure repair.
Compare 46712 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$2083.95
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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 46712 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
5,614
- Code
- 46712
- Physician work
- 35.54
- Practice expense
- 17.12
- Malpractice
- 9.52
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 35.54 | × 1.019 | 36.2153 |
| Practice expense | 17.12 | × 1.033 | 17.6850 |
| Malpractice | 9.52 | × 0.892 | 8.4918 |
| Total RVUs | 62.3921 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$2083.95
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 35.54 | 1.019 |
| Practice expense | 17.12 | 1.033 |
| Malpractice | 9.52 | 0.892 |
(35.54 × 1.019 + 17.12 × 1.033 + 9.52 × 0.892) × $33.4009 = $2083.95
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.
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 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.
5,61146706,,Repr of anal fistula w/glue,A,,2.38,2.33,NA,2.33,,0.62,5.33,5.33,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61246707,,Repair anorectal fist w/plug,A,,6.23,7.48,NA,7.48,,1.66,15.37,15.37,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61346710,,Repr per/vag pouch sngl proc,A,,16.71,10.80,NA,10.80,,4.46,31.97,31.97,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61446712,,Repr per/vag pouch dbl proc,A,,35.54,17.12,NA,17.12,,9.52,62.18,62.18,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61546715,,Rep perf anoper fistu,A,,7.43,7.18,NA,7.18,,1.98,16.59,16.59,0,090,0.09,0.81,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61646716,,Rep perf anoper/vestib fistu,A,,17.10,14.71,NA,14.71,,4.57,36.38,36.38,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61746730,,Construction of absent anus,A,,29.88,19.23,NA,19.23,,8.00,57.11,57.11,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537