CPT code 46080: Anal sphincterotomy, sphincter division2026 Medicare rate & RVUs in New Hampshire

Reports surgical division of the anal sphincter, commonly to treat a chronic anal fissure when sphincterotomy is the performed procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality498 Medicare services in 2024

In New Hampshire, Medicare pays $322.49 for 46080 in the office and $150.03 when it’s performed in a hospital or facility.

$322.49Office (non-facility)
$150.03Hospital or facility
+2.2%vs the national office rate ($315.64)

Check a contract rate as a % of Medicare · 46080 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 46080 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Hampshire
  2. What 46080 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 46080 covers

This procedure divides anal sphincter muscle, most often the internal sphincter in a lateral sphincterotomy for a chronic anal fissure. A colorectal or general surgeon typically performs it in an operating room or outpatient surgical facility. The operative note should identify the indication and describe the sphincter division performed.

Report 46080 when sphincterotomy itself is the service. If the surgeon excises the fissure and performs sphincterotomy as part of that operation, report 46200 rather than separately reporting 46080 for the included sphincterotomy. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and 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.

How New Hampshire compares for 46080

Across 109 of 109 payment localities, the office rate for 46080 runs from $277.09 in Arkansas to $413.04 in San Benito County, CA. New Hampshire pays $322.49. The RVUs are the same everywhere; the geographic indexes change the dollars.

46080 in New Hampshire vs other payment areas
  1. New Hampshire · this page$322.49
  2. Los Angeles, CA · California$353.24+$30.75
  3. Washington, DC area · District of Columbia$360.57+$38.08
  4. Miami, FL · Florida$349.56+$27.07
  5. Chicago, IL · Illinois$338.49+$16.00
  6. Manhattan, NY · New York$365.66+$43.17
  7. Alaska · Alaska$363.48+$40.99

Other areas in New Hampshire first, then benchmark localities. Bars start at $0.

Every other payment area

46080 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$281.40$136.44
ArkansasArkansas$277.09$134.78
ArizonaArizona$306.55$146.02
Bakersfield, CACalifornia$331.64$150.07
Chico, CACalifornia$330.28$148.71
El Centro, CACalifornia$330.37$148.79
Fresno, CACalifornia$330.28$148.71
Hanford, CACalifornia$330.28$148.71

46080 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$277.09

$371.66

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
46080 office rate range by state
State / territoryOffice rate rangeLocalities
AK$363.481
AL$281.401
AR$277.091
AZ$306.551
CA$330.28–$413.0429
CO$326.941
CT$337.441
DC$360.571
DE$311.791
FL$314.32–$349.563
GA$295.33–$322.652
GU$338.491
HI$338.491
IA$287.321
ID$289.641
IL$305.96–$338.494
IN$291.381
KS$286.681
KY$290.151
LA$289.98–$305.062
MA$325.14–$359.332
MD$317.72–$360.573
ME$292.08–$307.652
MI$298.86–$319.272
MN$310.411
MO$285.25–$305.253
MS$281.191
MT$315.611
NC$295.181
ND$305.921
NE$288.741
NH$322.491
NJ$340.49–$356.662
NM$300.911
NV$313.121
NY$299.92–$375.965
OH$296.881
OK$288.761
OR$309.91–$336.862
PA$296.94–$329.182
PR$317.781
RI$322.601
SC$296.681
SD$304.771
TN$288.301
TX$294.94–$326.538
UT$300.941
VA$307.14–$360.572
VI$317.781
VT$305.381
WA$324.30–$366.032
WI$295.191
WV$294.251
WY$311.381

See 46080 in every payment locality

How the 46080 rate is calculated

Each of 46080’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 · 46080

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.46

2.46 RVUs× 1.000 GPCI

Practice expense6.50

6.50 RVUs× 1.000 GPCI

Malpractice0.49

0.49 RVUs× 1.000 GPCI

Adjusted RVUs

9.4500

Conversion factor

$33.4009

Medicare rate

$315.64

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact New Hampshire inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,577

Code
46080
Physician work
2.46
Practice expense
6.50
Malpractice
0.49

GPCI2026.csv

74

Locality
New Hampshire
Physician work
1.000
Practice expense
1.041
Malpractice
0.875
Office calculation for 46080 in New Hampshire
ComponentRVULocality factorAdjusted
Physician work2.46× 1.0002.4600
Practice expense6.50× 1.0416.7665
Malpractice0.49× 0.8750.4287
Total RVUs9.6552
Conversion factor× 33.4009

Office rate, New Hampshire$322.49

Office: (2.46 × 1 + 6.5 × 1.041 + 0.49 × 0.875) × $33.4009 = $322.49

Facility: (2.46 × 1 + 1.54 × 1.041 + 0.49 × 0.875) × $33.4009 = $150.03

Open 46080 in the RVU calculator

Payment rules and modifiers for 46080

46080 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46080

Anal sphincterotomy, sphincter division

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 46080

Anal sphincterotomy, sphincter division

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

46080 without 51 · national office

$315.64

Anal sphincterotomy, sphincter division

46080-51 · Second procedure: 50%

$157.82

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%).

When to use modifier 51

How 46080 has changed in New Hampshire

46080 · Office / nonfacility

$322.49

Effective 2026-10-01

The base rate is $40.16 higher than on 2025-10-01, moving from $282.33 to $322.49 (14.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $282.33changed to$322.49

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.52 changed to 2.46
    • Practice expense RVU 5.57 changed to 6.50
    • Malpractice RVU 0.50 changed to 0.49
    • Practice expense GPCI 1.034 changed to 1.041
    • Malpractice GPCI 0.898 changed to 0.875

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $292.66changed to$282.33

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.64 changed to 5.57
    • Malpractice RVU 0.49 changed to 0.50

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $287.88changed to$292.66

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $300.17changed to$287.88

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.68 changed to 5.64
    • Malpractice RVU 0.50 changed to 0.49
    • Practice expense GPCI 1.036 changed to 1.034
    • Malpractice GPCI 0.907 changed to 0.898
  5. January 1, 2023

    RVU23A

    $308.18changed to$300.17

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.71 changed to 5.68
    • Practice expense GPCI 1.038 changed to 1.036
    • Malpractice GPCI 0.917 changed to 0.907

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $302.86changed to$308.18

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.51 changed to 5.71
    • Malpractice RVU 0.48 changed to 0.50

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $286.18changed to$302.86

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.71 changed to 5.51
    • Malpractice RVU 0.51 changed to 0.48
    • Practice expense GPCI 1.042 changed to 1.038
    • Malpractice GPCI 0.984 changed to 0.917

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $275.07changed to$286.18

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.38 changed to 4.71
    • Practice expense GPCI 1.045 changed to 1.042
    • Malpractice GPCI 1.050 changed to 0.984

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $265.74changed to$275.07

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.13 changed to 4.38
    • Malpractice RVU 0.52 changed to 0.51

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $261.68changed to$265.74

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.06 changed to 4.13
    • Practice expense GPCI 1.052 changed to 1.045
    • Malpractice GPCI 0.962 changed to 1.050

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $259.90changed to$261.68

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.05 changed to 4.06
    • Practice expense GPCI 1.058 changed to 1.052
    • Malpractice GPCI 0.873 changed to 0.962

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $260.59changed to$259.90

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.06 changed to 4.05
    • Malpractice RVU 0.50 changed to 0.52

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $259.29changed to$260.59

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $257.35changed to$259.29

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.05 changed to 4.06
    • Malpractice RVU 0.47 changed to 0.50
    • Practice expense GPCI 1.051 changed to 1.058
    • Malpractice GPCI 0.867 changed to 0.873

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$257.35

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$322.49$150.03RVU26D
2026-07-01$322.49$150.03RVU26C
2026-04-01$322.49$150.03RVU26B
2026-01-01$322.49$150.03RVU26A
2025-10-01$282.33$155.57RVU25D
2025-07-01$282.33$155.57RVU25C
2025-04-01$282.33$155.57RVU25B
2025-01-01$282.33$155.57RVU25A
2024-10-01$292.66$158.42RVU24D
2024-07-01$292.66$158.42RVU24C
2024-04-01$292.66$158.42RVU24B
2024-03-09$292.66$158.42RVU24AR
2024-01-01$287.88$155.84RVU24A
2023-10-01$300.17$161.15RVU23D
2023-07-01$300.17$161.15RVU23C
2023-04-01$300.17$161.15RVU23B
2023-01-01$300.17$161.15RVU23A
2022-10-01$308.18$163.06RVU22D
2022-07-01$308.18$163.06RVU22C
2022-04-01$308.18$163.06RVU22B
2022-01-01$308.18$163.06RVU22A
2021-10-01$302.86$163.05RVU21D
2021-07-01$302.86$163.05RVU21C
2021-04-01$302.86$163.05RVU21B
2021-01-01$302.86$163.05RVU21A
2020-10-01$286.18$168.10RVU20D
2020-07-01$286.18$168.10RVU20C
2020-04-01$286.18$168.10RVU20B
2020-01-01$286.18$168.10RVU20A
2019-10-01$275.07$168.87RVU19D
2019-07-01$275.07$168.87RVU19C
2019-04-01$275.07$168.87RVU19B
2019-01-01$275.07$168.87RVU19A
2018-10-01$265.74$169.44RVU18D
2018-07-01$265.74$169.44RVU18C
2018-04-01$265.74$169.44RVU18B
2018-01-01$265.74$169.44RVU18AR1
2017-10-01$261.68$167.67RVU17D
2017-07-01$261.68$167.67RVU17C
2017-04-01$261.68$167.67RVU17B
2017-01-01$261.68$167.67RVU17A
2016-10-01$259.90$165.57RVU16D
2016-07-01$259.90$165.57RVU16C
2016-04-01$259.90$165.57RVU16B
2016-01-01$259.90$165.57RVU16A
2015-10-01$260.59$165.93RVU15D
2015-07-01$260.59$165.93RVU15C
2015-04-01$259.29$165.10RVU15B
2015-01-01$259.29$165.10RVU15A
2014-10-01$257.35$164.36RVU14D
2014-07-01$257.35$164.36RVU14C
2014-04-01$257.35$164.36RVU14B
2014-01-01$257.35$164.36RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 46080 for an earlier date of service

Where the New Hampshire rate applies

New Hampshire is a Medicare payment area, not a city. Our Census mapping connects it to 100 cities and communities in New Hampshire. Some span more than one payment area; confirm with the service ZIP.

  • Alton
  • Amherst
  • Antrim
  • Ashland
  • Bartlett
  • Belmont
  • Bennington
  • Berlin

Browse all communities in New Hampshire

46080 billing questions

When should 46080 be reported instead of 46200?

Report 46080 when the service is sphincter division. Use 46200 when the surgeon performs fissurectomy and includes sphincterotomy in that operation; do not separately report 46080 for the included division.

What documentation supports 46080?

Document the indication, the sphincter muscle divided, and the operative technique. For a fissure, the note should make clear that sphincterotomy was performed rather than only an examination or another anorectal procedure.

Can modifier 50 be used for bilateral sphincterotomy?

No. The CMS bilateral adjustment does not apply to 46080, and modifier 50 is inappropriate for this code.

Are postoperative visits separately reportable during the global period?

Related postoperative visits for 10 days are included in the procedure's global period.

How does the multiple-procedure rule affect 46080?

When other procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 46080. 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
RVUs for 46080PPRRVU2026_Oct_nonQPP.csv, line 5,577 (RVU26D)
Geographic factors for New HampshireGPCI2026.csv, line 74 (RVU26D)

Open CMS sourceHow we calculate rates

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