Billing code 46030: Seton removalMedicare rate & RVUs in Washington
Report removal of a noncutting anal seton, commonly a loose drainage seton, when the clinician removes it from an anal fistula tract.
Medicare pays $294.69–$336.55 for 46030 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 46030 covers
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.
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.
Where 46030 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $294.69 | $80.50 |
| Seattle (King Cnty) | $336.55 | $86.97 |
How the 46030 rate is calculated
Each of 46030’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 46030
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.44Practice expense 6.82Malpractice 0.24
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 46030
The CMS indicators that decide how 46030 is paid alongside other services.
CMS payment indicators · 46030
Seton removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
46030 without 51 · national office
$283.91
Seton removal
46030-51 · Second procedure: 50%
$141.96
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
46030 compared with similar codes
Compare codes
46030 vs 46020 vs 46200 vs 46280: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 46020Seton placement
- 46020 reports placement of a seton; 46030 reports removal of a noncutting seton.
- 46200Fissure surgery
- 46200 describes fistulotomy, with use of a seton when performed. Choose 46030 when the service is seton removal rather than fistula incision and treatment.
- 46280Anal fistula surgery
- 46280 is for operative treatment of a complex anal fistula. 46030 is limited to removal of a noncutting seton.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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