No office rate
Both address perineal-vaginal pouch repair; 46712 is the double-procedure classification, while 46710 is the single-procedure classification.
On this page
CMS RVU26D · Effective 2026-10-01
46710 Pouch repair Medicare reimbursement rates in Kansas
Surgical reconstruction of a perineal-vaginal pouch classified as a single procedure, typically for a congenital anorectal abnormality. Compare 46710 office and facility rates across CMS payment localities in Kansas.
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 46710 in Kansas?
Kansas 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
$959.31
1 of 1 localities have a supported rate.
Payment area: Kansas
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.
Anorectal surgery
About 46710: Single-procedure perineal-vaginal pouch repair
Surgical reconstruction of a perineal-vaginal pouch classified as a single procedure, typically for a congenital anorectal abnormality.
This code describes operative repair of a perineal-vaginal pouch using the single-procedure classification. It is associated with reconstructive surgery for congenital anorectal abnormalities, often in pediatric patients. A pediatric surgeon or colorectal surgeon typically performs the repair in an operating room. The operative report should identify the pouch anatomy and describe the reconstruction performed.
Select this code when the documented repair fits the single-procedure distinction, rather than the double-procedure service reported with 46712. The note should support the diagnosis, anatomy, and single-procedure classification; do not choose based only on the number of operative steps. 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. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 46710
- 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 RVU16.71 · 52%
- Practice expense (office) RVU10.80 · 34%
- Malpractice RVU4.46 · 14%
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.
46710 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
46742 describes repair of imperforated anus. Use 46710 when the documented service is specifically a single-procedure perineal-vaginal pouch repair.
No office rate
46744 is for repair of a cloacal anomaly. The documented anatomy and repair, not general similarity as congenital anorectal surgery, distinguish it from 46710.
Compare 46710 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
Kansas →
Office / nonfacility
Unavailable
Facility
$959.31
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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 46710 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
5,613
- Code
- 46710
- Physician work
- 16.71
- Practice expense
- 10.80
- Malpractice
- 4.46
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 16.71 | × 1.000 | 16.7100 |
| Practice expense | 10.80 | × 0.904 | 9.7632 |
| Malpractice | 4.46 | × 0.504 | 2.2478 |
| Total RVUs | 28.7210 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$959.31
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 16.71 | 1 |
| Practice expense | 10.8 | 0.904 |
| Malpractice | 4.46 | 0.504 |
(16.71 × 1 + 10.8 × 0.904 + 4.46 × 0.504) × $33.4009 = $959.31
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.
46710 billing questions
How is 46710 distinguished from 46712?
46710 represents the single-procedure classification for perineal-vaginal pouch repair; 46712 represents the double-procedure classification. The operative documentation should support which classification applies.
Should modifier 50 be appended?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for the described anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports the single-procedure selection?
Document the pouch anatomy, the repair performed, and the basis for classifying it as a single-procedure repair rather than the double-procedure service.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
5,61046705,,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
5,61446712,,Repr per/vag pouch dbl proc,A,,35.54,17.12,NA,17.12,,9.52,62.18,62.18,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61546715,,Rep perf anoper fistu,A,,7.43,7.18,NA,7.18,,1.98,16.59,16.59,0,090,0.09,0.81,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61646716,,Rep perf anoper/vestib fistu,A,,17.10,14.71,NA,14.71,,4.57,36.38,36.38,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958