No office rate
This code describes perineal construction. Choose 46735 when the documented construction uses an abdominal approach.
On this page
CMS RVU26D · Effective 2026-10-01
46730 Anoplasty Medicare reimbursement rates
Reports surgical creation of an anal outlet through a perineal approach for a patient with an absent anus, typically from a congenital anorectal malformation. Compare 46730 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 46730?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 46730 pays more and less
Colorectal surgery
About 46730: Perineal anoplasty for absent anus
Reports surgical creation of an anal outlet through a perineal approach for a patient with an absent anus, typically from a congenital anorectal malformation.
This code represents surgery to create an anal opening through the perineum when the anus is absent, most often in a patient with a congenital anorectal malformation such as imperforate anus. A pediatric surgeon or colorectal surgeon typically performs the reconstruction in an operating room. The operative approach is the key distinction: this code describes perineal construction, rather than an abdominal or combined abdominal-perineal approach.
Report it when the operative note documents creation of the anal outlet by the perineal route and supports the congenital defect and reconstruction performed. The service has 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 50% multiple-procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this procedure.
CMS billing rules for 46730
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU29.88 · 52%
- Practice expense (office) RVU19.23 · 34%
- Malpractice RVU8.00 · 14%
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.
46730 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
This code is for the perineal approach alone; 46740 describes construction using both abdominal and perineal approaches.
No office rate
46742 describes a different repair of imperforate anus. Select based on the specific reconstruction documented, not just the diagnosis.
See how rates vary across the country
46730 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 46730 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $1711.27 |
| Alaska* | Office Unavailable | Facility $2328.31 |
| Arizona | Office Unavailable | Facility $1849.14 |
| Arkansas | Office Unavailable | Facility $1687.37 |
| Atlanta | Office Unavailable | Facility $1974.50 |
| Austin | Office Unavailable | Facility $1916.31 |
| Bakersfield | Office Unavailable | Facility $1883.67 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $2033.71 |
| Beaumont | Office Unavailable | Facility $1830.75 |
| Brazoria | Office Unavailable | Facility $1850.94 |
| Chicago | Office Unavailable | Facility $2263.76 |
| Chico | Office Unavailable | Facility $1862.17 |
| Colorado | Office Unavailable | Facility $1902.09 |
| Connecticut | Office Unavailable | Facility $2033.06 |
| Dallas | Office Unavailable | Facility $1875.99 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $2105.94 |
| Delaware | Office Unavailable | Facility $1877.82 |
| Detroit | Office Unavailable | Facility $2068.35 |
| East St. Louis | Office Unavailable | Facility $2127.09 |
| El Centro | Office Unavailable | Facility $1863.50 |
| Fort Lauderdale | Office Unavailable | Facility $2131.78 |
| Fort Worth | Office Unavailable | Facility $1873.05 |
| Fresno | Office Unavailable | Facility $1862.17 |
| Galveston | Office Unavailable | Facility $1865.05 |
| Hanford-Corcoran | Office Unavailable | Facility $1862.17 |
| Hawaii, Guam | Office Unavailable | Facility $1883.03 |
| Houston | Office Unavailable | Facility $2011.48 |
| Idaho | Office Unavailable | Facility $1715.32 |
| Indiana | Office Unavailable | Facility $1723.29 |
| Iowa | Office Unavailable | Facility $1691.80 |
| Kansas | Office Unavailable | Facility $1713.33 |
| Kentucky | Office Unavailable | Facility $1813.52 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1976.20 |
| Madera | Office Unavailable | Facility $1862.17 |
| Manhattan | Office Unavailable | Facility $2232.03 |
| Merced | Office Unavailable | Facility $1862.17 |
| Metropolitan Boston | Office Unavailable | Facility $2043.66 |
| Metropolitan Kansas City | Office Unavailable | Facility $1862.20 |
| Metropolitan Philadelphia | Office Unavailable | Facility $2003.40 |
| Metropolitan St. Louis | Office Unavailable | Facility $1877.23 |
| Miami | Office Unavailable | Facility $2342.42 |
| Minnesota | Office Unavailable | Facility $1738.04 |
| Mississippi | Office Unavailable | Facility $1748.50 |
| Modesto | Office Unavailable | Facility $1862.17 |
| Montana** | Office Unavailable | Facility $1906.99 |
| Napa | Office Unavailable | Facility $2043.19 |
| Nebraska | Office Unavailable | Facility $1691.87 |
| Nevada** | Office Unavailable | Facility $1863.54 |
| New Hampshire | Office Unavailable | Facility $1900.46 |
| New Mexico | Office Unavailable | Facility $1907.92 |
| New Orleans | Office Unavailable | Facility $1905.97 |
| North Carolina | Office Unavailable | Facility $1768.03 |
| North Dakota** | Office Unavailable | Facility $1748.80 |
| Northern Nj | Office Unavailable | Facility $2091.34 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $2321.79 |
| Ohio | Office Unavailable | Facility $1853.78 |
| Oklahoma | Office Unavailable | Facility $1779.21 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1951.63 |
| Portland | Office Unavailable | Facility $1926.38 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $2069.57 |
| Puerto Rico | Office Unavailable | Facility $1910.58 |
| Queens | Office Unavailable | Facility $2206.40 |
| Redding | Office Unavailable | Facility $1862.17 |
| Rest Of California | Office Unavailable | Facility $1862.17 |
| Rest Of Florida | Office Unavailable | Facility $2013.67 |
| Rest Of Georgia | Office Unavailable | Facility $1889.46 |
| Rest Of Illinois | Office Unavailable | Facility $2002.08 |
| Rest Of Louisiana | Office Unavailable | Facility $1822.44 |
| Rest Of Maine | Office Unavailable | Facility $1755.14 |
| Rest Of Maryland | Office Unavailable | Facility $1903.30 |
| Rest Of Massachusetts | Office Unavailable | Facility $1903.29 |
| Rest Of Michigan | Office Unavailable | Facility $1886.12 |
| Rest Of Missouri | Office Unavailable | Facility $1811.94 |
| Rest Of New Jersey | Office Unavailable | Facility $2032.46 |
| Rest Of New York | Office Unavailable | Facility $1796.05 |
| Rest Of Oregon | Office Unavailable | Facility $1825.60 |
| Rest Of Pennsylvania | Office Unavailable | Facility $1840.16 |
| Rest Of Texas | Office Unavailable | Facility $1848.85 |
| Rest Of Washington | Office Unavailable | Facility $1890.68 |
| Rhode Island | Office Unavailable | Facility $1918.83 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1947.87 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1924.16 |
| Salinas | Office Unavailable | Facility $1916.61 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1940.98 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $2121.12 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $2112.04 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $2177.22 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $2140.08 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1889.79 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1942.59 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1918.11 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1959.93 |
| Seattle (King Cnty) | Office Unavailable | Facility $2054.33 |
| South Carolina | Office Unavailable | Facility $1818.63 |
| South Dakota** | Office Unavailable | Facility $1730.10 |
| Southern Maine | Office Unavailable | Facility $1803.15 |
| Stockton | Office Unavailable | Facility $1862.17 |
| Suburban Chicago | Office Unavailable | Facility $2138.14 |
| Tennessee | Office Unavailable | Facility $1725.36 |
| Utah | Office Unavailable | Facility $1841.73 |
| Vallejo | Office Unavailable | Facility $2030.09 |
| Vermont | Office Unavailable | Facility $1769.10 |
| Virgin Islands | Office Unavailable | Facility $1910.58 |
| Virginia | Office Unavailable | Facility $1818.05 |
| Visalia | Office Unavailable | Facility $1862.17 |
| West Virginia | Office Unavailable | Facility $1938.55 |
| Wisconsin | Office Unavailable | Facility $1695.64 |
| Wyoming** | Office Unavailable | Facility $1838.05 |
| Yuba City | Office Unavailable | Facility $1862.17 |
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46730 billing questions
How does this differ from 46735?
The approach distinguishes these construction codes. This code describes perineal construction; 46735 is used for the abdominal approach.
When is 46740 the better fit?
Use 46740 when the documented construction uses both abdominal and perineal approaches, rather than the perineal approach alone.
What documentation supports this code?
The operative report should identify the absent anal opening, describe the reconstruction performed, and establish that the surgeon used a perineal approach.
Should modifier 50 be appended?
No. Modifier 50 is inappropriate for this construction; the anatomy and procedure do not represent a bilateral service.
Can an assistant surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,61446712,,Repr per/vag pouch dbl proc,A,,35.54,17.12,NA,17.12,,9.52,62.18,62.18,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61546715,,Rep perf anoper fistu,A,,7.43,7.18,NA,7.18,,1.98,16.59,16.59,0,090,0.09,0.81,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61646716,,Rep perf anoper/vestib fistu,A,,17.10,14.71,NA,14.71,,4.57,36.38,36.38,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61746730,,Construction of absent anus,A,,29.88,19.23,NA,19.23,,8.00,57.11,57.11,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61846735,,Construction of absent anus,A,,35.24,20.52,NA,20.52,,9.42,65.18,65.18,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61946740,,Construction of absent anus,A,,33.05,20.14,NA,20.14,,8.85,62.04,62.04,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62046742,,Repair of imperforated anus,A,,39.14,21.47,NA,21.47,,10.49,71.10,71.10,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00