$573.94
Both concern abscess drainage in the ischiorectal or perirectal region. Choose based on the precise service and abscess documented; 46045 specifically represents perirectal drainage under anesthesia.
On this page
CMS RVU26D · Effective 2026-10-01
46045 Abscess drainage Medicare reimbursement rates in Tennessee
Reports operative drainage of a perirectal abscess under anesthesia when the collection requires surgical access beyond superficial bedside drainage. Compare 46045 office and facility rates across CMS payment localities in Tennessee.
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 46045 in Tennessee?
Tennessee 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
$408.70
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 46045: Perirectal abscess drainage under anesthesia
Reports operative drainage of a perirectal abscess under anesthesia when the collection requires surgical access beyond superficial bedside drainage.
A surgeon, commonly a colorectal or general surgeon, opens and drains a perirectal abscess in an operative setting with anesthesia. The service is used for a collection requiring operative access rather than drainage of a superficial perianal abscess. The operative note should identify the abscess location and document the drainage performed.
Select this code when the documented service is perirectal abscess drainage under anesthesia; use the abscess site and the procedure performed to distinguish it from nearby drainage codes. This major surgery has 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, Medicare pays the highest-valued procedure in full and other procedures at 50%. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 46045
- 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 RVU5.72 · 43%
- Practice expense (office) RVU6.43 · 48%
- Malpractice RVU1.25 · 9%
127
Medicare services in 2024 · #4691 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.
46045 compared with similar codes
Office rates for Tennessee, from the same CMS release.
$243.59
46050 is for a superficial perianal abscess. This code describes drainage of a perirectal abscess under anesthesia.
No office rate
46060 includes treatment of an associated fistula by fistulectomy or fistulotomy along with abscess drainage. This code represents perirectal abscess drainage under anesthesia without that combined fistula procedure.
Compare 46045 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$408.70
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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 46045 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
5,573
- Code
- 46045
- Physician work
- 5.72
- Practice expense
- 6.43
- Malpractice
- 1.25
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.72 | × 1.000 | 5.7200 |
| Practice expense | 6.43 | × 0.909 | 5.8449 |
| Malpractice | 1.25 | × 0.537 | 0.6713 |
| Total RVUs | 12.2361 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$408.70
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.72 | 1 |
| Practice expense | 6.43 | 0.909 |
| Malpractice | 1.25 | 0.537 |
(5.72 × 1 + 6.43 × 0.909 + 1.25 × 0.537) × $33.4009 = $408.70
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.
46045 billing questions
How is this distinguished from 46040?
Use 46045 for documented perirectal abscess drainage under anesthesia. Select 46040 when the documented drainage service and abscess type fit that code instead.
When is 46050 a better fit?
46050 describes drainage of a superficial perianal abscess. This code is for perirectal abscess drainage under anesthesia, not a superficial perianal collection.
Should 46060 be reported when a fistula is treated?
46060 describes abscess drainage performed with fistulectomy or fistulotomy. Review the operative report to determine whether that fistula procedure was performed rather than reporting drainage alone.
What documentation supports this code?
Document the perirectal location, the abscess drainage performed, and that the service was carried out under anesthesia. The operative report should distinguish the collection from a superficial perianal abscess.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, Medicare applies the standard 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.
5,57046020,,Placement of seton,A,,1.81,1.15,NA,1.15,,0.36,3.32,3.32,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,57146030,,Removal anal seton oth mrk,A,,1.44,6.82,,0.73,,0.24,8.50,2.41,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
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
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780