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Billing code 46070: Anal septum incisionMedicare rate & RVUs

Reports surgical incision of an obstructing anal septum in an infant to open the anal outlet, rather than drainage of an abscess or fissure treatment.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $289.59 for 46070 nationally in a facility.

Medicare rate · 46070

Anal septum incision

Work RVUs
2.72
Total RVUs
8.67
Global days
090

National rate · 2026

$289.59

Facility setting, before claim adjustments.

See every locality for 46070 →Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 46070 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 46070 covers

A surgeon incises a thin septum obstructing the anal outlet in an infant, typically to correct a congenital outlet abnormality. The procedure is performed in an operative setting by a pediatric surgeon or colorectal surgeon. It is distinct from draining a perianal or deeper anorectal abscess and from operating on the anal sphincter for a fissure.

Report the code when the operative note documents incision of the anal septum in an infant; the diagnosis and findings should support that specific anatomy and procedure. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 multiple procedure reduction. Modifier 50 is inappropriate for this procedure. Assistant-at-surgery payment requires documentation of medical necessity; 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.

Where 46070 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

46070 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$257.31
Alaska*Unavailable$335.57
ArizonaUnavailable$280.71
ArkansasUnavailable$253.29
AtlantaUnavailable$297.49
AustinUnavailable$297.16
BakersfieldUnavailable$298.68
Baltimore/Surr. CntysUnavailable$309.49
BeaumontUnavailable$272.16
BrazoriaUnavailable$283.45

46070 rates by state

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

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Local rates. Clear comparisons.

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

View every state and territory as a table
46070 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 46070 rate is calculated

Each of 46070’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 · 46070

RVUs × geographic indexes × conversion factor

Work2.72

2.72 RVUs× 1.000 GPCI

Practice expense5.23

5.23 RVUs× 1.000 GPCI

Malpractice0.72

0.72 RVUs× 1.000 GPCI

Adjusted RVUs

8.6700

Conversion factor

$33.4009

Medicare rate

$289.59

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

Payment rules and modifiers for 46070

46070 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46070

Anal septum incision

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 46070

Anal septum incision

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

46070 without 51 · national facility

$289.59

Anal septum incision

46070-51 · Second procedure: 50%

$144.80

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

46070 compared with similar codes

Compare codes · National

4 codes, side by side

  • 46070

    Anal septum incision2.72 wRVU

    Not priced

  • 45905

    Anal dilation2.29 wRVU

    Not priced

  • 46080

    Anal sphincterotomy2.46 wRVU

    $315.64

  • 46045

    Abscess drainage5.72 wRVU

    Not priced

How to choose

45905Anal dilation
Choose this code when the operative service is anal sphincter dilation under anesthesia. Use 46070 when the surgeon incises an anal septum in an infant.
46080Anal sphincterotomy
46080 is for sphincterotomy to treat an anal fissure. It does not describe incision of an infant's anal septum.
46045Abscess drainage
46045 describes transanal drainage of an anorectal abscess under anesthesia. It is not used for incision of a congenital anal septum.

Codes related to 46070

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

Codes related to 46070
CodeHow it relatesNational office range
Used instead
45905Anal dilationAnal sphincter dilation is a different approach when the documented treatment is dilation rather than septum incision.No office rate
45990Anorectal examAnorectal examination under anesthesia is relevant when evaluation is performed without the septum incision.No office rate
46080Anal sphincterotomyAnal sphincterotomy treats an anal fissure; it is not the procedure for an infant anal septum.$277.09–$413.04

46070 billing questions

How is this different from anal sphincter dilation?

This code is for incision of an anal septum in an infant. Dilation is a different approach for anal narrowing and should be selected when the documented procedure is dilation rather than septum incision.

Can an anorectal examination under anesthesia be billed separately?

The operative report should clarify whether the service was a diagnostic examination alone or the examination was part of the septum procedure. Do not treat the examination as a separate service solely because it is documented.

Does this code have a 90-day global period?

Yes. CMS includes the day-before preoperative visit and 90 days of related postoperative care in the global period.

Can modifier 50 be used?

No. CMS identifies bilateral adjustment as inappropriate for this procedure.

When is an assistant at surgery payable?

CMS permits assistant-at-surgery payment only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

How are other procedures in the same session handled?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

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 46070PPRRVU2026_Oct_nonQPP.csv, line 5,576 (RVU26D)

Open CMS sourceHow we calculate rates

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