FeeBase
Log inGet started
Menu

CPT code 46080: Anal sphincterotomy, sphincter division2026 Medicare rate & RVUs in Queens, NY

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 Queens, NY, Medicare pays $367.64 for 46080 in the office and $171.82 when it’s performed in a hospital or facility.

$367.64Office (non-facility)
$171.82Hospital or facility
+16.5%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $367.64. The RVUs are the same everywhere; the geographic indexes change the dollars.

46080 in Queens, NY vs other payment areas
  1. Queens, NY · this page$367.64
  2. Manhattan, NY · New York$365.66−$1.98
  3. NYC suburbs and Long Island, NY · New York$375.96+$8.32
  4. Poughkeepsie and northern NYC suburbs, NY · New York$343.40−$24.24
  5. Rest of New York · New York$299.92−$67.72
  6. Los Angeles, CA · California$353.24−$14.40
  7. Washington, DC area · District of Columbia$360.57−$7.07

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

Every other payment area

46080 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$349.56$177.10
Chicago, ILIllinois$338.49$172.00
AlaskaAlaska$363.48$187.05
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

46080 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 46080 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work2.46× 1.0642.6174
Practice expense6.50× 1.1827.6830
Malpractice0.49× 1.4420.7066
Total RVUs11.0070
Conversion factor× 33.4009

Office rate, Queens, NY$367.64

Office: (2.46 × 1.064 + 6.5 × 1.182 + 0.49 × 1.442) × $33.4009 = $367.64

Facility: (2.46 × 1.064 + 1.54 × 1.182 + 0.49 × 1.442) × $33.4009 = $171.82

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

Codes related to 46080

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 46080
CodeHow it relatesOffice range, Queens, NY
Used instead
46200Fissure surgery, fissure excisionUse for fissurectomy when sphincterotomy is included in the fissure operation.$618.75

How 46080 has changed in Queens, NY

46080 · Office / nonfacility

$367.64

Effective 2026-10-01

The base rate is $41.88 higher than on 2025-10-01, moving from $325.76 to $367.64 (12.9%).

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

    $325.76changed to$367.64

    • 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
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $337.53changed to$325.76

    • 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

    $332.03changed to$337.53

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $358.81changed to$332.03

    • 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
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $380.79changed to$358.81

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.71 changed to 5.68
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $373.52changed to$380.79

    • 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

    $346.22changed to$373.52

    • 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
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $323.95changed to$346.22

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.38 changed to 4.71
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $313.56changed to$323.95

    • 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

    $310.13changed to$313.56

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.06 changed to 4.13
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $309.39changed to$310.13

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.05 changed to 4.06
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $309.37changed to$309.39

    • 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

    $307.83changed to$309.37

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $299.99changed to$307.83

    • 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
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $301.72changed to$299.99

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.57 changed to 4.05
    • Malpractice RVU 0.49 changed to 0.47
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $301.72

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$367.64$171.82RVU26D
2026-07-01$367.64$171.82RVU26C
2026-04-01$367.64$171.82RVU26B
2026-01-01$367.64$171.82RVU26A
2025-10-01$325.76$179.26RVU25D
2025-07-01$325.76$179.26RVU25C
2025-04-01$325.76$179.26RVU25B
2025-01-01$325.76$179.26RVU25A
2024-10-01$337.53$182.40RVU24D
2024-07-01$337.53$182.40RVU24C
2024-04-01$337.53$182.40RVU24B
2024-03-09$337.53$182.40RVU24AR
2024-01-01$332.03$179.42RVU24A
2023-10-01$358.81$196.17RVU23D
2023-07-01$358.81$196.17RVU23C
2023-04-01$358.81$196.17RVU23B
2023-01-01$358.81$196.17RVU23A
2022-10-01$380.79$209.10RVU22D
2022-07-01$380.79$209.10RVU22C
2022-04-01$380.79$209.10RVU22B
2022-01-01$380.79$209.10RVU22A
2021-10-01$373.52$208.12RVU21D
2021-07-01$373.52$208.12RVU21C
2021-04-01$373.52$208.12RVU21B
2021-01-01$373.52$208.12RVU21A
2020-10-01$346.22$208.65RVU20D
2020-07-01$346.22$208.65RVU20C
2020-04-01$346.22$208.65RVU20B
2020-01-01$346.22$208.65RVU20A
2019-10-01$323.95$201.99RVU19D
2019-07-01$323.95$201.99RVU19C
2019-04-01$323.95$201.99RVU19B
2019-01-01$323.95$201.99RVU19A
2018-10-01$313.56$202.96RVU18D
2018-07-01$313.56$202.96RVU18C
2018-04-01$313.56$202.96RVU18B
2018-01-01$313.56$202.96RVU18AR1
2017-10-01$310.13$202.90RVU17D
2017-07-01$310.13$202.90RVU17C
2017-04-01$310.13$202.90RVU17B
2017-01-01$310.13$202.90RVU17A
2016-10-01$309.39$202.49RVU16D
2016-07-01$309.39$202.49RVU16C
2016-04-01$309.39$202.49RVU16B
2016-01-01$309.39$202.49RVU16A
2015-10-01$309.37$202.09RVU15D
2015-07-01$309.37$202.09RVU15C
2015-04-01$307.83$201.08RVU15B
2015-01-01$307.83$201.08RVU15A
2014-10-01$299.99$194.08RVU14D
2014-07-01$299.99$194.08RVU14C
2014-04-01$299.99$194.08RVU14B
2014-01-01$299.99$194.08RVU14A
2013-10-01$301.72$186.65RVU13D
2013-07-01$301.72$186.65RVU13C
2013-04-01$301.72$186.65RVU13B
2013-01-01$301.72$186.65RVU13AR

Price 46080 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 46080 pays in Queens, NY?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 46080 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist