CPT code 46716 denotes surgical correction of a low imperforate or malformed anus, including closure of anoperineal or anovestibular fistula, creation of a new anal opening, and repositioning of the rectal pouch. This procedure addresses congenital anorectal malformations that can have significant implications for bowel function, infection risk, and long-term quality of life. Nationally, such reconstructive pelvic procedures are clinically significant because they involve specialized pediatric and colorectal surgical expertise and can drive utilization in tertiary care centers.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the procedure, typical sites of service and service classification, and the types of benchmarks and policy issues commonly associated with complex surgical reconstruction codes. The publication outlines reimbursement benchmarking approaches, common modifier usage patterns (listed separately), and considerations payers and providers monitor for authorization and coverage decisions.

This summary provides a concise guide to what CPT code 46716 represents, why it matters to payers and health systems, and the topics covered in the full publication, including national benchmarking, policy implications, and coding context for surgical repair of anorectal malformations.