No office rate
46742 describes repair of an imperforate anus. Report 46753 when the documented procedure is reconstruction of the anus rather than that specific repair.
On this page
CMS RVU26D · Effective 2026-10-01
46753 Anal reconstruction Medicare reimbursement rates
Reconstructive surgery that restores anal anatomy is reported when the operative work rebuilds the anus rather than treating an isolated stricture or sphincter defect. Compare 46753 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 46753?
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
Facility setting
$541.98–$746.52
109 of 109 localities have a 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 46753 pays more and less
Anorectal surgery
About 46753: Surgical reconstruction of the anus
Reconstructive surgery that restores anal anatomy is reported when the operative work rebuilds the anus rather than treating an isolated stricture or sphincter defect.
CPT 46753 represents operative reconstruction of the anus. A colorectal or pediatric surgeon may perform it in an operating room when the documented anatomy and planned work call for rebuilding the anal structure. Distinguish this service from repair directed at a narrowed anal canal, an absent anus, or an isolated anal sphincter defect; those procedures have separate code families. The operative report should describe the anatomic problem and the reconstructive work performed.
Report 46753 when the operative service supports anal reconstruction, not merely because the procedure involves the anus. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. If 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.
CMS billing rules for 46753
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.67 · 47%
- Practice expense (office) RVU7.40 · 40%
- Malpractice RVU2.33 · 13%
17
Medicare services in 2024 · #6010 by national volume
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.
46753 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
46730 is in the construction family for an absent anus. 46753 describes reconstruction, not creation of an anus that is absent.
No office rate
46750 is used for anal sphincter repair. Choose 46753 when the operative work reconstructs the anus itself rather than repairing the sphincter.
No office rate
46700 is for repair of anal stricture. 46753 concerns anal reconstruction, not treatment of a narrowed anal canal.
See how rates vary across the country
46753 · 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 46753 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 $549.91 |
| Alaska* | Office Unavailable | Facility $740.49 |
| Arizona | Office Unavailable | Facility $595.71 |
| Arkansas | Office Unavailable | Facility $541.98 |
| Atlanta | Office Unavailable | Facility $635.04 |
| Austin | Office Unavailable | Facility $620.62 |
| Bakersfield | Office Unavailable | Facility $613.38 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $655.70 |
| Beaumont | Office Unavailable | Facility $586.81 |
| Brazoria | Office Unavailable | Facility $597.55 |
| Chicago | Office Unavailable | Facility $718.62 |
| Chico | Office Unavailable | Facility $607.12 |
| Colorado | Office Unavailable | Facility $616.83 |
| Connecticut | Office Unavailable | Facility $655.74 |
| Dallas | Office Unavailable | Facility $605.14 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $683.00 |
| Delaware | Office Unavailable | Facility $605.20 |
| Detroit | Office Unavailable | Facility $659.31 |
| East St. Louis | Office Unavailable | Facility $673.72 |
| El Centro | Office Unavailable | Facility $607.51 |
| Fort Lauderdale | Office Unavailable | Facility $680.67 |
| Fort Worth | Office Unavailable | Facility $603.68 |
| Fresno | Office Unavailable | Facility $607.12 |
| Galveston | Office Unavailable | Facility $601.78 |
| Hanford-Corcoran | Office Unavailable | Facility $607.12 |
| Hawaii, Guam | Office Unavailable | Facility $615.67 |
| Houston | Office Unavailable | Facility $644.42 |
| Idaho | Office Unavailable | Facility $553.79 |
| Indiana | Office Unavailable | Facility $556.53 |
| Iowa | Office Unavailable | Facility $546.64 |
| Kansas | Office Unavailable | Facility $552.25 |
| Kentucky | Office Unavailable | Facility $580.53 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $645.53 |
| Madera | Office Unavailable | Facility $607.12 |
| Manhattan | Office Unavailable | Facility $718.76 |
| Merced | Office Unavailable | Facility $607.12 |
| Metropolitan Boston | Office Unavailable | Facility $665.84 |
| Metropolitan Kansas City | Office Unavailable | Facility $597.71 |
| Metropolitan Philadelphia | Office Unavailable | Facility $644.94 |
| Metropolitan St. Louis | Office Unavailable | Facility $602.87 |
| Miami | Office Unavailable | Facility $743.70 |
| Minnesota | Office Unavailable | Facility $566.96 |
| Mississippi | Office Unavailable | Facility $559.91 |
| Modesto | Office Unavailable | Facility $607.12 |
| Montana** | Office Unavailable | Facility $614.42 |
| Napa | Office Unavailable | Facility $673.13 |
| Nebraska | Office Unavailable | Facility $547.14 |
| Nevada** | Office Unavailable | Facility $601.83 |
| New Hampshire | Office Unavailable | Facility $614.98 |
| New Mexico | Office Unavailable | Facility $609.70 |
| New Orleans | Office Unavailable | Facility $610.58 |
| North Carolina | Office Unavailable | Facility $569.92 |
| North Dakota** | Office Unavailable | Facility $568.35 |
| Northern Nj | Office Unavailable | Facility $677.66 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $746.52 |
| Ohio | Office Unavailable | Facility $593.70 |
| Oklahoma | Office Unavailable | Facility $570.77 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $638.33 |
| Portland | Office Unavailable | Facility $626.72 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $667.43 |
| Puerto Rico | Office Unavailable | Facility $616.13 |
| Queens | Office Unavailable | Facility $712.49 |
| Redding | Office Unavailable | Facility $607.12 |
| Rest Of California | Office Unavailable | Facility $607.12 |
| Rest Of Florida | Office Unavailable | Facility $642.85 |
| Rest Of Georgia | Office Unavailable | Facility $602.82 |
| Rest Of Illinois | Office Unavailable | Facility $636.89 |
| Rest Of Louisiana | Office Unavailable | Facility $582.88 |
| Rest Of Maine | Office Unavailable | Facility $565.39 |
| Rest Of Maryland | Office Unavailable | Facility $614.06 |
| Rest Of Massachusetts | Office Unavailable | Facility $616.51 |
| Rest Of Michigan | Office Unavailable | Facility $603.11 |
| Rest Of Missouri | Office Unavailable | Facility $578.44 |
| Rest Of New Jersey | Office Unavailable | Facility $656.45 |
| Rest Of New York | Office Unavailable | Facility $579.10 |
| Rest Of Oregon | Office Unavailable | Facility $590.47 |
| Rest Of Pennsylvania | Office Unavailable | Facility $590.03 |
| Rest Of Texas | Office Unavailable | Facility $594.42 |
| Rest Of Washington | Office Unavailable | Facility $612.84 |
| Rhode Island | Office Unavailable | Facility $619.83 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $632.08 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $629.18 |
| Salinas | Office Unavailable | Facility $626.74 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $636.07 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $701.32 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $698.68 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $719.57 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $708.75 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $617.75 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $637.69 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $627.60 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $643.51 |
| Seattle (King Cnty) | Office Unavailable | Facility $670.92 |
| South Carolina | Office Unavailable | Facility $584.12 |
| South Dakota** | Office Unavailable | Facility $562.90 |
| Southern Maine | Office Unavailable | Facility $583.63 |
| Stockton | Office Unavailable | Facility $607.12 |
| Suburban Chicago | Office Unavailable | Facility $683.36 |
| Tennessee | Office Unavailable | Facility $556.05 |
| Utah | Office Unavailable | Facility $591.81 |
| Vallejo | Office Unavailable | Facility $669.32 |
| Vermont | Office Unavailable | Facility $573.66 |
| Virgin Islands | Office Unavailable | Facility $616.13 |
| Virginia | Office Unavailable | Facility $587.49 |
| Visalia | Office Unavailable | Facility $607.12 |
| West Virginia | Office Unavailable | Facility $615.74 |
| Wisconsin | Office Unavailable | Facility $550.34 |
| Wyoming** | Office Unavailable | Facility $594.34 |
| Yuba City | Office Unavailable | Facility $607.12 |
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46753 billing questions
How is 46753 distinguished from anal sphincter repair codes?
Use 46753 for reconstruction of the anus itself. When the documented work is directed at repairing the anal sphincter, consider the applicable sphincter-repair code instead.
Is 46753 appropriate for constructing an anus that is absent?
Codes 46730–46740 describe construction of an absent anus. Select 46753 only when the operative documentation supports reconstruction rather than construction.
What documentation supports reporting 46753?
The operative report should identify the anatomic problem and describe the reconstructive work performed. The code should reflect the actual procedure, not simply the fact that surgery involved the anus.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for 46753.
What happens when 46753 is performed with another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. 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 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.
5,62346748,,Repair of cloacal anomaly,A,,69.63,29.17,NA,29.17,,18.65,117.45,117.45,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62446750,,Repair of anal sphincter,A,,11.85,6.66,NA,6.66,,2.06,20.57,20.57,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62546751,,Repair of anal sphincter,A,,9.07,8.39,NA,8.39,,2.42,19.88,19.88,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62646753,,Reconstruction of anus,A,,8.67,7.40,NA,7.40,,2.33,18.40,18.40,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62746754,,Removal of suture from anus,A,,2.93,8.07,,3.83,,0.42,11.42,7.18,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62846760,,Repair of anal sphincter,A,,17.01,11.93,NA,11.93,,2.46,31.40,31.40,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62946761,,Repair of anal sphincter,A,,14.91,7.36,NA,7.36,,2.58,24.85,24.85,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00