Billing code 46744: Cloacal repairMedicare rate & RVUs in Utah
Reports partial operative reconstruction of a congenital cloacal anomaly, where the urinary, genital, and intestinal outlets share a common channel.
CMS doesn’t publish an office rate for 46744 in Utah.
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 46744 covers
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.
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 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $3,199.36 |
How the 46744 rate is calculated
Each of 46744’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 · 46744
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 57.47Practice expense 26.06Malpractice 15.39
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 46744
46744 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 46744
Cloacal 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 · 46744
Cloacal 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
46744 without 51 · national facility
$3,304.02
Cloacal repair
46744-51 · Second procedure: 50%
$1,652.01
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%).
46744 compared with similar codes
Compare codes
46744 vs 46746 vs 46748 vs 46742: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 46746Cloacal repair
- Use 46744 for partial cloacal repair and 46746 for intermediate repair. The operative report should support the selected level.
- 46748Cloacal repair
- 46748 represents extensive cloacal repair, whereas 46744 is for partial repair. Select by the extent of reconstruction performed.
- 46742Anorectal repair
- 46742 addresses imperforate anus. Use 46744 when the operation treats a cloacal anomaly involving a common outlet, rather than an imperforate anus alone.
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 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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