No office rate
Use 46744 for partial cloacal repair and 46746 for intermediate repair. The operative report should support the selected level.
On this page
CMS RVU26D · Effective 2026-10-01
46744 Cloacal repair Medicare reimbursement rates in Massachusetts
Reports partial operative reconstruction of a congenital cloacal anomaly, where the urinary, genital, and intestinal outlets share a common channel. Compare 46744 office and facility rates across CMS payment localities in Massachusetts.
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 46744 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$3276.51–$3495.04
2 of 2 localities have a supported rate.
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 46744: Partial cloacal anomaly repair
Reports partial operative reconstruction of a congenital cloacal anomaly, where the urinary, genital, and intestinal outlets share a common channel.
A cloacal anomaly is a congenital malformation in which the urinary, genital, and intestinal tracts converge into a common channel. Code 46744 describes a partial repair rather than the intermediate or extensive repairs represented by other codes in this series. The operation is typically performed in the operating room by a pediatric surgeon with colorectal expertise, often with pediatric urology or gynecology involvement. It may be part of staged reconstruction for a child with complex congenital pelvic anatomy.
Select the partial-repair level from the operative work performed, not from the diagnosis alone or the planned future stages. The operative report should describe the anatomy, structures addressed, reconstruction completed, and why the service was partial. CMS 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 others at 50%. 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 46744
- 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 RVU57.47 · 58%
- Practice expense (office) RVU26.06 · 26%
- Malpractice RVU15.39 · 16%
26
Medicare services in 2024 · #5760 by national volume
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.
46744 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
46748 represents extensive cloacal repair, whereas 46744 is for partial repair. Select by the extent of reconstruction performed.
No office rate
46742 addresses imperforate anus. Use 46744 when the operation treats a cloacal anomaly involving a common outlet, rather than an imperforate anus alone.
Compare 46744 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$3495.04
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$3276.51
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
46744 billing questions
How does 46744 differ from 46746 and 46748?
46744 represents partial repair; 46746 and 46748 represent intermediate and extensive repair, respectively. Match the code to the operative extent documented, not simply to the cloacal diagnosis.
Is 46744 an add-on code?
No. It reports the partial cloacal repair itself and is not an add-on to another primary procedure.
What documentation supports the partial-repair level?
Document the congenital anatomy, the structures reconstructed during the session, the extent of repair completed, and any staged plan that explains why the operation was partial.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the standard multiple-procedure reduction applies.
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.
5,61846735,,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
5,62446750,,Repair of anal sphincter,A,,11.85,6.66,NA,6.66,,2.06,20.57,20.57,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00