No office rate
Use 46700 for anal stricture repair without sphincterotomy. Code 46705 describes the repair when sphincterotomy is included.
On this page
CMS RVU26D · Effective 2026-10-01
46705 Anal stricture repair Medicare reimbursement rates in Alaska
Surgical repair of anal narrowing that includes sphincterotomy, reported when the operative treatment addresses the stricture using this technique. Compare 46705 office and facility rates across CMS payment localities in Alaska.
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 46705 in Alaska?
Alaska 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
$686.03
1 of 1 localities have a supported rate.
Payment area: Alaska*
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 46705: Anal stricture repair with sphincterotomy
Surgical repair of anal narrowing that includes sphincterotomy, reported when the operative treatment addresses the stricture using this technique.
This operation widens a narrowed anal canal and includes division of sphincter muscle as part of the repair. A colorectal surgeon typically performs it in an operating room for a patient whose anal stricture causes clinically significant narrowing. The operative report should establish the stricture and describe the repair and sphincterotomy performed; the code is distinguished from repair without sphincterotomy.
Report one service for the operative procedure, supported by documentation of the stricture and the technique used. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 46705
- 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 RVU7.24 · 42%
- Practice expense (office) RVU8.09 · 47%
- Malpractice RVU1.93 · 11%
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.
46705 compared with similar codes
Office rates for Alaska, from the same CMS release.
No office rate
46750 addresses repair of the anal sphincter itself, rather than widening an anal stricture with sphincterotomy.
$363.48
46080 describes sphincterotomy performed as its own service, commonly for anal fissure treatment. It is not a substitute for stricture repair that includes sphincterotomy.
Compare 46705 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
Alaska* →
Office / nonfacility
Unavailable
Facility
$686.03
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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 46705 in Alaska*.
PPRRVU2026_Oct_nonQPP.csv
5,610
- Code
- 46705
- Physician work
- 7.24
- Practice expense
- 8.09
- Malpractice
- 1.93
GPCI2026.csv
5
- Locality
- Alaska*
- Physician work
- 1.500
- Practice expense
- 1.065
- Malpractice
- 0.551
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.24 | × 1.500 | 10.8600 |
| Practice expense | 8.09 | × 1.065 | 8.6159 |
| Malpractice | 1.93 | × 0.551 | 1.0634 |
| Total RVUs | 20.5393 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alaska*$686.03
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.24 | 1.5 |
| Practice expense | 8.09 | 1.065 |
| Malpractice | 1.93 | 0.551 |
(7.24 × 1.5 + 8.09 × 1.065 + 1.93 × 0.551) × $33.4009 = $686.03
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.
46705 billing questions
How does this differ from 46700?
46705 applies when the anal stricture repair includes sphincterotomy. Use 46700 for the repair without sphincterotomy.
Is sphincterotomy separately reportable?
The sphincterotomy is part of the service represented by 46705. Do not separately report it as an additional procedure when it is performed as part of this repair.
What documentation supports reporting 46705?
Document the anal stricture and describe the operative repair, including that sphincterotomy was performed. The operative note should make clear that this was stricture treatment, not repair of a sphincter injury.
Can modifier 50 be used?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
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.
5,60746614,,Anoscopy control bleeding,A,,0.98,4.35,,0.70,,0.16,5.49,1.84,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60846615,,Anoscopy,A,,1.46,4.07,,0.84,,0.21,5.74,2.51,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60946700,,Repair of anal stricture,A,,9.56,8.00,NA,8.00,,1.59,19.15,19.15,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61046705,,Repair of anal stricture,A,,7.24,8.09,NA,8.09,,1.93,17.26,17.26,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61146706,,Repr of anal fistula w/glue,A,,2.38,2.33,NA,2.33,,0.62,5.33,5.33,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61246707,,Repair anorectal fist w/plug,A,,6.23,7.48,NA,7.48,,1.66,15.37,15.37,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61346710,,Repr per/vag pouch sngl proc,A,,16.71,10.80,NA,10.80,,4.46,31.97,31.97,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609