No office rate
Choose 46750 for a primary perineal repair. Choose 46751 when the operative service is a secondary perineal reconstruction.
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CMS RVU26D · Effective 2026-10-01
46751 Anal sphincter repair Medicare reimbursement rates in New York
Reports secondary perineal reconstruction of a disrupted anal sphincter, such as repair of a chronic defect associated with fecal incontinence. Compare 46751 office and facility rates across CMS payment localities in New York.
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 46751 in New York?
New York has 5 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 5 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$625.99–$805.63
5 of 5 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.
Where 46751 pays more and less in New York
Colorectal surgery
About 46751: Secondary perineal anal sphincter repair
Reports secondary perineal reconstruction of a disrupted anal sphincter, such as repair of a chronic defect associated with fecal incontinence.
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.
CMS billing rules for 46751
- 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 RVU9.07 · 46%
- Practice expense (office) RVU8.39 · 42%
- Malpractice RVU2.42 · 12%
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 compared with similar codes
Office rates for New York, from the same CMS release.
No office rate
46760 represents anal sphincter repair by a transabdominal approach. This code is for secondary repair through a perineal approach.
No office rate
46700 addresses repair of an anal stricture, not reconstruction of a disrupted anal sphincter.
No office rate
46753 describes reconstruction of the anus. Use 46751 when the documented procedure is secondary repair of the anal sphincter through a perineal approach.
Compare 46751 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.
5 of 5 payment localities
Manhattan →
Office / nonfacility
Unavailable
Facility
$776.16
Nyc Suburbs/Long Island →
Office / nonfacility
Unavailable
Facility
$805.63
Poughkpsie/N Nyc Suburbs →
Office / nonfacility
Unavailable
Facility
$721.24
Queens →
Office / nonfacility
Unavailable
Facility
$770.13
Rest Of New York →
Office / nonfacility
Unavailable
Facility
$625.99
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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 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.
5,62246746,,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
5,62546751,,Repair of anal sphincter,A,,9.07,8.39,NA,8.39,,2.42,19.88,19.88,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62646753,,Reconstruction of anus,A,,8.67,7.40,NA,7.40,,2.33,18.40,18.40,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62746754,,Removal of suture from anus,A,,2.93,8.07,,3.83,,0.42,11.42,7.18,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,62846760,,Repair of anal sphincter,A,,17.01,11.93,NA,11.93,,2.46,31.40,31.40,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00