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CPT code 46750: Anal sphincter repair2026 Medicare rate & RVUs

Reports operative repair of the anal sphincter to address fecal incontinence associated with sphincter injury or a defect.

CMS RVU26DEffective Oct 1, 2026109 payment localities499 Medicare services in 2024

Medicare pays $687.06 for 46750 nationally in a facility.

Medicare rate · 46750

Anal sphincter repair

Office or facility?

Work RVUs
11.85
Total RVUs
20.57
Global days
090

National rate · 2026

$687.06

Facility setting, before claim adjustments.

See every locality for 46750 →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.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 46750 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 46750 covers

This operation restores continuity or function of the anal sphincter when a defect contributes to fecal incontinence. A colorectal surgeon or other surgeon experienced in anorectal procedures may perform it, commonly in a hospital or outpatient surgical facility. The operative approach and repair method depend on the defect and the surgeon’s plan; the service is distinct from surgery directed at an anal stricture or fistula.

Report the code when the operative record supports repair of the anal sphincter for incontinence, including the identified defect and work performed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur 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 code. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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 46750 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

46750 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$629.39
AlaskaUnavailable$868.52
ArizonaUnavailable$670.25
ArkansasUnavailable$622.32
Atlanta, GAUnavailable$705.63
Austin, TXUnavailable$692.91
Bakersfield, CAUnavailable$689.03
Baltimore area, MDUnavailable$725.94
Beaumont, TXUnavailable$662.15
Brazoria, TXUnavailable$673.08

46750 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
46750 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 46750 rate is calculated

Each of 46750’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 · 46750

RVUs × geographic indexes × conversion factor

Office or facility?

Work11.85

11.85 RVUs× 1.000 GPCI

Practice expense6.66

6.66 RVUs× 1.000 GPCI

Malpractice2.06

2.06 RVUs× 1.000 GPCI

Adjusted RVUs

20.5700

Conversion factor

$33.4009

Medicare rate

$687.06

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

Payment rules and modifiers for 46750

46750 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46750

Anal sphincter repair

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 46750

Anal sphincter repair

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

46750 without 51 · national facility

$687.06

Anal sphincter repair

46750-51 · Second procedure: 50%

$343.53

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

46750 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 46750

    Anal sphincter repair11.85 wRVU

    Not priced

  • 46700

    Anal repair9.56 wRVU

    Not priced

  • 46706

    Fistula repair2.38 wRVU

    Not priced

  • 46707

    Fistula repair6.23 wRVU

    Not priced

  • 46753

    Anal reconstruction8.67 wRVU

    Not priced

How to choose

46700Anal repair
46700 addresses an anal stricture. Choose 46750 when the operative target is repair of the anal sphincter for incontinence.
46706Fistula repair
46706 describes fistula treatment using glue. It is not the code for sphincter repair performed to address incontinence.
46707Fistula repair
46707 describes fistula treatment using a plug. Use 46750 when the documented operation repairs the anal sphincter.
46753Anal reconstruction
46753 describes reconstruction of the anus. 46750 is directed specifically to anal sphincter repair for incontinence.

Codes related to 46750

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

Codes related to 46750
CodeHow it relatesNational office range
Same family
46751Anal sphincter repairA related anal sphincter repair code; select the code matching the documented procedure.No office rate
46760Anal sphincter repairAnother anal sphincter repair code in the same operative code family.No office rate
46761Anal sphincter repairA neighboring anal sphincter repair code; distinguish by the procedure documented.No office rate
Used instead
46700Anal repairRepairs an anal stricture rather than an anal sphincter defect causing incontinence.No office rate
46706Fistula repairTreats an anal fistula with glue rather than repairing the sphincter for incontinence.No office rate
46707Fistula repairTreats an anorectal fistula with a plug, not a sphincter defect.No office rate

46750 billing questions

When is 46750 appropriate instead of an anal fistula repair code?

Use 46750 for operative repair of the anal sphincter to address incontinence. Codes for fistula repair describe treatment of a fistulous tract, not sphincter repair alone.

What documentation supports reporting 46750?

The operative report should describe the sphincter defect or injury, its relationship to incontinence, and the repair performed.

Can modifier 50 be appended?

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

What postoperative care is included?

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

How does CMS handle another procedure performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

May an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is 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 46750PPRRVU2026_Oct_nonQPP.csv, line 5,624 (RVU26D)

Open CMS sourceHow we calculate rates

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