No office rate
46020 reports placement of a seton; 46030 reports removal of a noncutting seton.
On this page
CMS RVU26D · Effective 2026-10-01
46030 Seton removal Medicare reimbursement rates in Vermont
Report removal of a noncutting anal seton, commonly a loose drainage seton, when the clinician removes it from an anal fistula tract. Compare 46030 office and facility rates across CMS payment localities in Vermont.
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 46030 in Vermont?
Vermont 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
$277.67
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$76.29
1 of 1 localities have a supported rate.
Payment area: Vermont
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 46030: Removal of noncutting anal seton
Report removal of a noncutting anal seton, commonly a loose drainage seton, when the clinician removes it from an anal fistula tract.
This service covers removing a noncutting seton from an anal fistula tract, often after it has maintained drainage or controlled inflammation. A colorectal or general surgeon may remove a loose seton in an office or procedure setting, or during an operative encounter. The service is removal only; placement of a seton or operative treatment of the fistula describes different work.
Document the seton’s removal and the clinical status of the fistula tract. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 46030
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.44 · 17%
- Practice expense (office) RVU6.82 · 80%
- Malpractice RVU0.24 · 3%
355
Medicare services in 2024 · #3842 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.
46030 compared with similar codes
Office rates for Vermont, from the same CMS release.
$516.90
46200 describes fistulotomy, with use of a seton when performed. Choose 46030 when the service is seton removal rather than fistula incision and treatment.
No office rate
46280 is for operative treatment of a complex anal fistula. 46030 is limited to removal of a noncutting seton.
Compare 46030 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
Vermont →
Office / nonfacility
$277.67
Facility
$76.29
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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 46030 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
5,571
- Code
- 46030
- Physician work
- 1.44
- Practice expense
- 6.82
- Malpractice
- 0.24
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.44 | × 1.000 | 1.4400 |
| Practice expense | 6.82 | × 0.990 | 6.7518 |
| Malpractice | 0.24 | × 0.506 | 0.1214 |
| Total RVUs | 8.3132 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$277.67
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.44 | 1 |
| Practice expense | 6.82 | 0.99 |
| Malpractice | 0.24 | 0.506 |
(1.44 × 1 + 6.82 × 0.99 + 0.24 × 0.506) × $33.4009 = $277.67
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.44 | 1 |
| Practice expense | 0.73 | 0.99 |
| Malpractice | 0.24 | 0.506 |
(1.44 × 1 + 0.73 × 0.99 + 0.24 × 0.506) × $33.4009 = $76.29
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.
46030 billing questions
How is removal different from seton placement?
46030 describes taking out a noncutting seton. Use 46020 when the service is placement of a seton.
Is this the code for fistulotomy or definitive fistula surgery?
No. Report 46030 for seton removal itself; operative fistula treatment, such as fistulotomy, is a different service.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are same-session procedures paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction.
What documentation supports reporting 46030?
Document that a noncutting anal seton was removed and describe the fistula tract’s status. Same-day preoperative and postoperative care is included in the 0-day global period.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. 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.
5,56845990,,Surg dx exam anorectal,A,,1.76,0.87,NA,0.87,,0.35,2.98,2.98,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56945999,,Unlisted procedure rectum,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817