Billing code 46751: Anal sphincter repairMedicare rate & RVUs in Kansas
Reports secondary perineal reconstruction of a disrupted anal sphincter, such as repair of a chronic defect associated with fecal incontinence.
CMS doesn’t publish an office rate for 46751 in Kansas.
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 46751 covers
This code describes a secondary repair of the anal sphincter through a perineal approach, typically to reconstruct a sphincter disrupted by an earlier injury or operation. A colorectal surgeon or another surgeon experienced in pelvic floor reconstruction may perform it for a chronic defect associated with impaired continence. The operative note should establish the sphincter defect and describe the secondary reconstruction and perineal approach.
Report the code for the secondary repair, not a primary repair or an operation using a different approach. The service has a 90-day global period, which includes 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% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Do not report modifier 50 for this repair.
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.
46751 in Kansas
| Payment locality | Office | Facility |
|---|---|---|
| Kansas | Unavailable | $597.02 |
How the 46751 rate is calculated
Each of 46751’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 · 46751
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.07Practice expense 8.39Malpractice 2.42
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 46751
46751 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 46751
Anal sphincter 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 · 46751
Anal sphincter 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
46751 without 51 · national facility
$664.01
Anal sphincter repair
46751-51 · Second procedure: 50%
$332.01
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%).
46751 compared with similar codes
Compare codes
46751 vs 46750 vs 46760 vs 46700 vs 46753: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 46750Anal sphincter repair
- Choose 46750 for a primary perineal repair. Choose 46751 when the operative service is a secondary perineal reconstruction.
- 46760Anal sphincter repair
- 46760 represents anal sphincter repair by a transabdominal approach. This code is for secondary repair through a perineal approach.
- 46700Anal repair
- 46700 addresses repair of an anal stricture, not reconstruction of a disrupted anal sphincter.
- 46753Anal reconstruction
- 46753 describes reconstruction of the anus. Use 46751 when the documented procedure is secondary repair of the anal sphincter through a perineal approach.
46751 billing questions
How does this differ from 46750?
46751 is for a secondary perineal repair, such as reconstruction of an established defect. 46750 describes a primary perineal repair.
When should a different approach code be considered?
Use the code that matches the operative approach and service performed. A transabdominal anal sphincter repair is represented by a different code in this family, not 46751.
Are related postoperative visits separately reported?
Related postoperative care during the 90-day global period is included. The period also includes the preoperative visit on the day before surgery.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Should modifier 50 be appended?
No. This repair is not reported as a bilateral procedure, and modifier 50 is inappropriate.
What documentation supports 46751?
Document the established sphincter defect, why secondary reconstruction was performed, and the perineal approach. The operative report should distinguish the repair from a primary repair or transabdominal procedure.
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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