CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 46288 RVU and Medicare Payment (2026)
Repair anal fistula — 7.61 work RVU, about $552.45 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 7.61
- PE RVU (non-facility)
- 7.5
- PE RVU (facility)
- 7.5
- MP RVU
- 1.43
- Office payment
- $552.45
- Facility payment
- $552.45
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 46288 in a non-facility setting with national GPCI: (7.61 + 7.5 + 1.43) × $33.4009 ≈ $552.45. The same code in a facility setting pays about $552.45 because facility PE RVU (7.5) replaces office PE RVU.
What changes by locality
GPCI moves 46288 non-facility payment from $493.96 to $674.38 across CMS localities — from Arkansas to Alaska. Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 46288?
7.61. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 46288 in 2026?
About $552.45 non-facility ($552.45 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (7.61) and malpractice RVU stay fixed; only practice expense changes (7.5 office vs 7.5 facility). That is the entire office-vs-facility payment gap.