CPT 46040 Surgery - Digestive
I&d ischiorct&/perirct absc Cost
Body System: Digestive
Medicare Facility Rate
$435
CMS PFS CY2026
Medicare Non-Facility Rate
$630
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
5.24
Work RVU
6.58
Facility PE RVU
1.20
Malpractice RVU
18.87
Total RVU
Frequently Asked Questions
How much does I&d ischiorct&/perirct absc cost?
The Medicare facility rate is $435. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does I&d ischiorct&/perirct absc cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $435.