No office rate
46730 is for constructing an anus; 46742 is for repairing imperforate-anus anatomy. The operative report should establish which service was performed.
On this page
CMS RVU26D · Effective 2026-10-01
46742 Anorectal repair Medicare reimbursement rates in Kansas
Surgical repair of congenital imperforate anus, reported for an operative correction of the anorectal malformation rather than creation of an absent anal opening. Compare 46742 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 46742 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
$2132.17
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.
Pediatric colorectal surgery
About 46742: Imperforate anus repair
Surgical repair of congenital imperforate anus, reported for an operative correction of the anorectal malformation rather than creation of an absent anal opening.
This code represents operative correction of congenital imperforate anus, a condition in which the normal anal opening is absent or improperly formed. A surgeon with pediatric colorectal, pediatric surgical, or related expertise performs the repair, typically in a hospital operating room. The specific anatomy and operative plan determine the technique; the code is not a label for routine examination or follow-up of the malformation.
Report the code when the operative record supports repair of imperforate-anus anatomy, distinguishing it from procedures that construct an anus when one is absent. The note should identify the malformation and describe the repair performed. This major surgery includes 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% multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 46742
- 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 RVU39.14 · 55%
- Practice expense (office) RVU21.47 · 30%
- Malpractice RVU10.49 · 15%
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.
46742 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
46735 describes construction of an absent anus, whereas 46742 describes repair. Do not select based only on the diagnosis name.
No office rate
46740 belongs to the construction-of-anus code group; 46742 is the repair code for imperforate anus.
No office rate
46744 addresses repair of a cloacal anomaly. Use 46742 for repair of imperforate anus when the documented operation is not cloacal-anomaly repair.
Compare 46742 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
$2132.17
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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 46742 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
5,620
- Code
- 46742
- Physician work
- 39.14
- Practice expense
- 21.47
- Malpractice
- 10.49
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 39.14 | × 1.000 | 39.1400 |
| Practice expense | 21.47 | × 0.904 | 19.4089 |
| Malpractice | 10.49 | × 0.504 | 5.2870 |
| Total RVUs | 63.8358 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$2132.17
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 39.14 | 1 |
| Practice expense | 21.47 | 0.904 |
| Malpractice | 10.49 | 0.504 |
(39.14 × 1 + 21.47 × 0.904 + 10.49 × 0.504) × $33.4009 = $2132.17
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.
46742 billing questions
How is this distinguished from codes for construction of an absent anus?
46742 describes repair of imperforate-anus anatomy. Codes 46730, 46735, and 46740 describe construction of an anus; the operative report should support which service was performed.
Does the 90-day global period include postoperative visits?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in this major-surgery global period.
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% when performed in the same session.
Can modifier 50 be reported?
No. The anatomy and descriptor make modifier 50 inappropriate for this code.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
5,61746730,,Construction of absent anus,A,,29.88,19.23,NA,19.23,,8.00,57.11,57.11,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61846735,,Construction of absent anus,A,,35.24,20.52,NA,20.52,,9.42,65.18,65.18,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61946740,,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
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