No office rate
This code is for the abdominal approach; 46744 is used when the cloacal repair is performed through a perineal approach.
On this page
CMS RVU26D · Effective 2026-10-01
46746 Cloacal repair Medicare reimbursement rates in Arkansas
Reports abdominal-approach reconstruction of a congenital cloacal malformation, in which urinary, genital, and intestinal tracts converge into a shared channel. Compare 46746 office and facility rates across CMS payment localities in Arkansas.
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 46746 in Arkansas?
Arkansas 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
$3221.25
1 of 1 localities have a supported rate.
Payment area: Arkansas
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.
Pediatric colorectal surgery
About 46746: Abdominal Approach Cloacal Anomaly Repair
Reports abdominal-approach reconstruction of a congenital cloacal malformation, in which urinary, genital, and intestinal tracts converge into a shared channel.
This code describes operative reconstruction of a congenital cloacal malformation through an abdominal approach. In this rare anomaly, the urinary, genital, and intestinal tracts converge into a shared channel or opening. The procedure is generally performed in a hospital operating room by a pediatric colorectal or general surgeon, sometimes with pediatric urology or gynecology expertise involved based on the anatomy and operative plan.
Select this code when the operative report documents repair of a cloacal anomaly using an abdominal approach; the perineal-only and combined abdominal-perineal approaches have separate sibling codes. Documentation should identify the anomaly, operative route, reconstructive work, and any separately participating surgeons. CMS classifies the service as major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 46746
- 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 RVU63.80 · 59%
- Practice expense (office) RVU27.76 · 26%
- Malpractice RVU17.08 · 16%
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.
46746 compared with similar codes
Office rates for Arkansas, from the same CMS release.
No office rate
Use 46748 when the repair uses both abdominal and perineal approaches. This code identifies the abdominal approach.
No office rate
46742 is for repair of imperforate anus. Use this code when the operative diagnosis and repair are for a cloacal anomaly.
Compare 46746 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
Arkansas →
Office / nonfacility
Unavailable
Facility
$3221.25
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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 46746 in Arkansas.
PPRRVU2026_Oct_nonQPP.csv
5,622
- Code
- 46746
- Physician work
- 63.80
- Practice expense
- 27.76
- Malpractice
- 17.08
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 63.80 | × 1.000 | 63.8000 |
| Practice expense | 27.76 | × 0.859 | 23.8458 |
| Malpractice | 17.08 | × 0.515 | 8.7962 |
| Total RVUs | 96.4420 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arkansas$3221.25
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 63.8 | 1 |
| Practice expense | 27.76 | 0.859 |
| Malpractice | 17.08 | 0.515 |
(63.8 × 1 + 27.76 × 0.859 + 17.08 × 0.515) × $33.4009 = $3221.25
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.
46746 billing questions
How is this code distinguished from the other cloacal repair codes?
Use this code for the abdominal approach. The sibling codes distinguish a perineal-only approach from a combined abdominal and perineal approach.
What documentation supports reporting this code?
The operative report should establish the cloacal anomaly, describe the abdominal route, and document the reconstructive work performed.
Does the code include related postoperative care?
Yes. 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 reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Should modifier 50 be appended?
No. Modifier 50 is inappropriate for this repair and its anatomy.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction.
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.
5,61946740,,Construction of absent anus,A,,33.05,20.14,NA,20.14,,8.85,62.04,62.04,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62046742,,Repair of imperforated anus,A,,39.14,21.47,NA,21.47,,10.49,71.10,71.10,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62146744,,Repair of cloacal anomaly,A,,57.47,26.06,NA,26.06,,15.39,98.92,98.92,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62246746,,Repair of cloacal anomaly,A,,63.80,27.76,NA,27.76,,17.08,108.64,108.64,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62346748,,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
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
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541