Billing code 46705: Anal stricture repairMedicare rate & RVUs in Iowa
Surgical repair of anal narrowing that includes sphincterotomy, reported when the operative treatment addresses the stricture using this technique.
CMS doesn’t publish an office rate for 46705 in Iowa.
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 46705 covers
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.
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 in Iowa
| Payment locality | Office | Facility |
|---|---|---|
| Iowa | Unavailable | $514.66 |
How the 46705 rate is calculated
Each of 46705’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 · 46705
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.24Practice expense 8.09Malpractice 1.93
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 46705
46705 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 46705
Anal stricture 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) | 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 · 46705
Anal stricture 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
46705 without 51 · national facility
$576.50
Anal stricture repair
46705-51 · Second procedure: 50%
$288.25
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%).
46705 compared with similar codes
Compare codes
46705 vs 46700 vs 46750 vs 46080: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 46700Anal repair
- Use 46700 for anal stricture repair without sphincterotomy. Code 46705 describes the repair when sphincterotomy is included.
- 46750Anal sphincter repair
- 46750 addresses repair of the anal sphincter itself, rather than widening an anal stricture with sphincterotomy.
- 46080Anal sphincterotomy
- 46080 describes sphincterotomy performed as its own service, commonly for anal fissure treatment. It is not a substitute for stricture repair that includes sphincterotomy.
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 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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