Billing code 46730: AnoplastyMedicare rate & RVUs in Guam
Reports surgical creation of an anal outlet through a perineal approach for a patient with an absent anus, typically from a congenital anorectal malformation.
CMS doesn’t publish an office rate for 46730 in Guam.
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 46730 covers
This code represents surgery to create an anal opening through the perineum when the anus is absent, most often in a patient with a congenital anorectal malformation such as imperforate anus. A pediatric surgeon or colorectal surgeon typically performs the reconstruction in an operating room. The operative approach is the key distinction: this code describes perineal construction, rather than an abdominal or combined abdominal-perineal approach.
Report it when the operative note documents creation of the anal outlet by the perineal route and supports the congenital defect and reconstruction performed. The service has 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 other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this procedure.
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.
46730 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $1,883.03 |
How the 46730 rate is calculated
Each of 46730’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 · 46730
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 29.88Practice expense 19.23Malpractice 8.00
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 46730
46730 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 46730
Anoplasty
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 46730
Anoplasty
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
46730 without 51 · national facility
$1,907.53
Anoplasty
46730-51 · Second procedure: 50%
$953.77
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%).
46730 compared with similar codes
Compare codes
46730 vs 46735 vs 46740 vs 46742: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 46735Anorectal reconstruction
- This code describes perineal construction. Choose 46735 when the documented construction uses an abdominal approach.
- 46740Anoplasty
- This code is for the perineal approach alone; 46740 describes construction using both abdominal and perineal approaches.
- 46742Anorectal repair
- 46742 describes a different repair of imperforate anus. Select based on the specific reconstruction documented, not just the diagnosis.
46730 billing questions
How does this differ from 46735?
The approach distinguishes these construction codes. This code describes perineal construction; 46735 is used for the abdominal approach.
When is 46740 the better fit?
Use 46740 when the documented construction uses both abdominal and perineal approaches, rather than the perineal approach alone.
What documentation supports this code?
The operative report should identify the absent anal opening, describe the reconstruction performed, and establish that the surgeon used a perineal approach.
Should modifier 50 be appended?
No. Modifier 50 is inappropriate for this construction; the anatomy and procedure do not represent a bilateral service.
Can an assistant surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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