No office rate
The approach distinguishes these repairs: 46760 is perineal, while 46761 is abdominal.
On this page
CMS RVU26D · Effective 2026-10-01
46760 Anal sphincter repair Medicare reimbursement rates in Alabama
Reports operative repair of the anal sphincter through a perineal approach, such as repair of a documented sphincter disruption. Compare 46760 office and facility rates across CMS payment localities in Alabama.
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 46760 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$963.32
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
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.
Colorectal surgery
About 46760: Anal sphincter repair, perineal approach
Reports operative repair of the anal sphincter through a perineal approach, such as repair of a documented sphincter disruption.
This service repairs the anal sphincter through an incision and operative exposure in the perineum. A surgeon, commonly a colorectal surgeon or another surgeon managing anorectal or pelvic injury, identifies and repairs the disrupted sphincter. The clinical situation may involve sphincter damage associated with childbirth or other trauma; the operative approach and work performed must support this code.
Select the code from the documented operation, not from symptoms such as fecal incontinence alone. The operative report should establish the sphincter repair and perineal approach; distinguish it from an incontinence sphincteroplasty and from an abdominal approach. CMS assigns a 90-day global period, including 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 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 46760
- 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 RVU17.01 · 54%
- Practice expense (office) RVU11.93 · 38%
- Malpractice RVU2.46 · 8%
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.
46760 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
46750 describes anal sphincteroplasty for incontinence. Use 46760 for documented repair through a perineal approach.
No office rate
46751 is for secondary sphincteroplasty for incontinence; 46760 identifies repair by the perineal approach.
Compare 46760 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.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$963.32
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 46760 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
5,628
- Code
- 46760
- Physician work
- 17.01
- Practice expense
- 11.93
- Malpractice
- 2.46
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.01 | × 1.000 | 17.0100 |
| Practice expense | 11.93 | × 0.875 | 10.4387 |
| Malpractice | 2.46 | × 0.566 | 1.3924 |
| Total RVUs | 28.8411 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$963.32
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.01 | 1 |
| Practice expense | 11.93 | 0.875 |
| Malpractice | 2.46 | 0.566 |
(17.01 × 1 + 11.93 × 0.875 + 2.46 × 0.566) × $33.4009 = $963.32
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
46760 billing questions
How does this differ from 46761?
46760 is the perineal approach to anal sphincter repair. Use 46761 when the documented repair is performed through an abdominal approach.
When would 46750 or 46751 be a better fit?
Those codes describe anal sphincteroplasty for incontinence, with 46751 used for a secondary repair. Choose 46760 when the documented service is sphincter repair by the perineal approach rather than that incontinence sphincteroplasty service.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for repair on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
How are other procedures in the same session handled?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment needs supporting documentation, and 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 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.
5,62546751,,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
5,63046900,,Destruction anal lesion(s),A,,1.86,5.92,,1.84,,0.26,8.04,3.96,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,63146910,,Destruction anal lesion(s),A,,1.86,6.72,,1.73,,0.30,8.88,3.89,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515