Billing code 46700: Anal repairMedicare rate & RVUs in Alabama
Surgical enlargement of a narrowed adult anal canal is reported for repair of a fixed stricture, including post-traumatic narrowing.
CMS doesn’t publish an office rate for 46700 in Alabama.
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 9 sections
What 46700 covers
This procedure surgically enlarges a narrowed anal canal through anoplasty. It is used for an adult with a fixed anal stricture that impairs passage of stool; post-traumatic narrowing is a typical example. A colorectal or general surgeon usually performs the repair in an operating room, with the operative approach guided by the location and extent of the scarred canal.
Report this code for the adult stricture repair, not for an infant repair or an operation directed at an anal sphincter defect. The operative report should establish the anal narrowing, its clinical effect, the repair performed, and the patient’s age. 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 the others at 50%. Modifier 50 is inappropriate for this service. 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.
46700 in Alabama
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Unavailable | $583.18 |
How the 46700 rate is calculated
Each of 46700’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 · 46700
RVUs × geographic indexes × conversion factor
Work9.56
9.56 RVUs× 1.000 GPCI
Practice expense8.00
8.00 RVUs× 1.000 GPCI
Malpractice1.59
1.59 RVUs× 1.000 GPCI
Adjusted RVUs
19.1500
Conversion factor
$33.4009
Medicare rate
$639.63
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 46700
46700 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 46700
Anal repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 46700
Anal 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
46700 without 51 · national facility
$639.63
Anal repair
46700-51 · Second procedure: 50%
$319.82
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%).
46700 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 46705Anal stricture repair
- Use 46700 for adult anal stricture repair and 46705 for the infant counterpart. The patient category is the key distinction.
- 46750Anal sphincter repair
- 46700 addresses a narrowed anal canal. Consider 46750 when the operation repairs the anal sphincter rather than enlarging a stricture.
- 46760Anal sphincter repair
- 46700 is selected for fixed anal canal narrowing; 46760 describes a different operative target, anal sphincter repair.
46700 billing questions
How do I distinguish this code from 46705?
This code is for adult anal stricture repair; 46705 is the related code for an infant. Confirm the patient category and the operative indication in the record.
Can modifier 50 be reported for repair on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code because the descriptor or anatomy does not support modifier 50.
Are related postoperative visits separately reported during the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be billed?
CMS does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
How is this code affected when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid at 50%.
What documentation supports reporting this repair?
Document the adult patient’s fixed anal narrowing, its effect on function, and the surgical repair performed. The record should distinguish canal stenosis from a sphincter defect.
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
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