46280 Remove anal fist complex
Also known as: complex fistula excision, difficult fistula surgery, fistula reconstruction
Surgical removal of a complex anal fistula. Complex fistulas are those with multiple tracts, extrasphincteric origin, or recurrent disease.
In Plain Language
removing a complicated fistula tunnel; surgery on a difficult or recurrent anal fistula
Clinical Context
Used for complex fistulas including transsphincteric, extrasphincteric, or recurrent fistulas. May require staged procedures or tissue flaps to preserve continence.
RVU Breakdown
| Work RVU | 6.23 |
| Total RVU | 6.23 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 90-day global period, which includes the day of the procedure, 1 day preoperative, and 90 days of postoperative care. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 6.23, this code ranks in the 41st percentile among Surgery codes — 1.3x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 46280?
CPT 46280 (Remove anal fist complex) is a Surgery code. Surgical removal of a complex anal fistula. Complex fistulas are those with multiple tracts, extrasphincteric origin, or recurrent disease.
What is the wRVU value for CPT 46280?
The work RVU for CPT 46280 is 6.23. This code is primarily used by Colorectal Surgery. It has a 90-day global period.
When is CPT 46280 used?
Used for complex fistulas including transsphincteric, extrasphincteric, or recurrent fistulas. May require staged procedures or tissue flaps to preserve continence.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.