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See a sample rate comparisonCPT 46060 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Incision Of Rectal Abscess, Incision And Drainage Of Ischiorectal Or Intramural Abscess With Fistulectomy Or Fistulotomy Submuscular With Or Without Placement Of Seton
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 78 - Return to OR - related procedure 58 - Staged or related procedure during postoperative period GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 46060 |
| Medicaid Fee Schedule | View Medicaid rates for 46060 |
National average reimbursement for CPT 46060 by major payers:
$578.64
$621.92
$682.74
$777.39
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CPT 46060
5 of 25 sample ratesHigher to lower in this preview
Chca Mainland, L.P., Mainland Medical Center
$2,675.00Published rateBristol Ambulatory Surgery Center, LLC
$1,258.00Published rateParkside Surgery Center, LLC
Parkside Surgery Center
$800.00Published rateEllicott City Ambulatory Surgery Center, Lllp, Ellicott City Ambulatory Surgery Center
Ellicott City Ambulatory Surgery Center Lllp
$644.00Published rateBentonville Ambulatory Surgery Center, LLC
Bentonville Ambulatory Surgery Center LLC
$404.00Published rate
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See a sample payer proposalCPT 46060 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46060 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 46060 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 46020-CPT | Moderate | Rectal Surgery, Surgery To Close Off An Abnormal Passageway (Fistula). This Is A Two-Stage Procedure. First A Type Of Gauze Is Placed In The Rectum To Mark And Surround The Fistula. The Gauze Is Pulled Tight Gradually Until The Fistula Is Closed. |
| 46030-CPT | Moderate | Rectal Surgery, Surgery To Close Off An Abnormal Passageway (Fistula). This Is A Two-Stage Procedure. First A Type Of Gauze Is Placed In The Rectum To Mark And Surround The Fistula. The Gauze Is Pulled Tight Gradually Until The Fistula Is Closed. |
| 46045-CPT | Moderate | Incision Of Rectal Abscess, Incision And Drainage Of Intramural Intramuscular Or Submucosal Abscess Transanal Under Anesthesia |
| 46060-CPT | Moderate | Incision Of Rectal Abscess, Incision And Drainage Of Ischiorectal Or Intramural Abscess With Fistulectomy Or Fistulotomy Submuscular With Or Without Placement Of Seton |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46060. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46060 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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