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    v1.0.30
    OpenPayerBilling CodesRepair Procedures on the AnusCPT cpt-46730-high-imperforate-anus-repair-perineal-sacroperineal
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    CPT 46730: Repair of High Imperforate Anus, No Fistula

    Medicare pays $1927 on average nationally for this procedure.

    CPT code 46730 describes surgical repair of a high imperforate anus without a fistula, performed via a perineal or sacroperineal approach; the service is a reconstructive anorectal procedure typically provided in an inpatient hospital or specialized pediatric surgical center where neonatal or pediatric colorectal surgeries are performed.

    For related coverage guidance, see recent payer policy updates: Surgical Procedures, Outpatient Surgical Procedures - Site of Service, Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults.

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    Clinical & Coding Specifications

    Clinical Context

    A full-term neonate is born with an imperforate anus identified on newborn exam. The infant has a high-type imperforate anus without a perineal fistula on inspection and radiographic evaluation (cross-table lateral or invertogram) demonstrating the rectal pouch above the levator ani complex. The typical workflow includes initial stabilization in the neonatal unit, bowel decompression if needed, and consultation with pediatric surgery. Definitive repair is scheduled: the surgeon performs a posterior sagittal or sacroperineal approach to mobilize the rectum and create a neo-anus within the sphincter complex, consistent with the description of 46730. Preoperative evaluation includes anesthesia assessment, imaging to characterize the level of the malformation, and counseling with pediatric surgery and nursing. Postoperative care involves pain control, monitoring for complications (wound infection, stricture, fistula), stool regimen, and planned outpatient follow-up for anal dilations and functional assessment.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    54050Reconstruction of hypospadias, with repair of chordee; primary (one-stage repair)May be performed in the same patient population when concurrent genitourinary anomalies require repair; related as a concurrent reconstructive procedure when documented.
    44120Bowel resection, small intestine, with anastomosisMay be required if there are associated intestinal complications or segmental bowel issues discovered intraoperatively; related as a more extensive abdominal procedure.
    49000Unlisted laparoscopy procedure, abdomen, peritoneumMay be used for laparoscopic assessment or abdominal mobilization if a combined approach (sacroperineal with abdominal mobilization) is employed; reported when no specific laparoscopy CPT matches the service.
    51702Repair of urethrocutaneous fistula (simple closure)Relevant if an associated fistula is present or requires simultaneous repair; related as an adjunct genitourinary repair.
    58661Laparoscopy, surgical; with lysis of adhesions (salpingolysis) — (Note: example of pelvic laparoscopy codes used in pediatric pelvic access)May be used for intra-abdominal mobilization in select high anorectal malformations when laparoscopic pelvic access is needed; related as an adjunct access procedure.

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2080P0207X
    363L00000X
    208VP0000X
    207P00000X
    317400000X
    2080P0204X
    208000000X
    213EP1101X

    Related Payer Policy Updates

    Specialty: General Surgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Surgical ProceduresUnitedHealthcare2026-09-01
    Outpatient Surgical Procedures - Site of ServiceUnitedHealthcare2026-09-01
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01
    Medical Necessity Guidelines — Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Ambulatory Surgery Center (ASC) - Site of Care PolicyKaiser Permanente2026-08-01

    Related Codes

    CPT-46700-ANOPLASTY-ANAL-STRICTURE-REPAIR

    CPT 46700: Anoplasty for Anal Stricture, Adult

    CPT-46705-ANOPLASTY-INFANT-ANAL-STRICTURE

    CPT 46705: Anoplasty for Infant Anal Stricture

    CPT-46706-ANAL-FISTULA-REPAIR-FIBRIN-GLUE

    CPT 46706: Fibrin Glue Repair of Anal Fistula

    CPT-46707-ANORECTAL-FISTULA-REPAIR-TISSUE-FLAP

    CPT 46707: Anorectal Fistula Repair with Tissue Closure

    CPT-46710-ILEOANAL-POUCH-FISTULA-REPAIR-POUCH-ADVANCEMENT-PERINEAL

    CPT 46710: Ileoanal Pouch Advancement and Fistula/Sinus Repair

    CPT-46712-ILEOANAL-POUCH-FISTULA-REPAIR-POUCH-ADVANCEMENT

    CPT 46712: Ileoanal Pouch Fistula/Sinus Repair with Pouch Advancement

    CPT-46715-REPAIR-LOW-IMPERFORATE-ANUS-ANORECTAL-RECONSTRUCTION

    CPT 46715: Repair of Low Imperforate or Malformed Anus

    CPT-46716-LOW-IMPERFORATE-ANUS-REPAIR-ANORECTAL-MALFORMATION

    CPT 46716: Repair of Low Imperforate or Malformed Anus

    CPT-46735-HIGH-IMPERFORATE-ANUS-REPAIR-TRANSABDOMINAL-SACROPERINEAL

    CPT 46735: Repair of High Imperforate Anus, No Fistula

    CPT-46740-REPAIR-HIGH-IMPERFORATE-ANUS-RECTOVAGINAL-RECTOURETHRAL-FISTULA

    CPT 46740: Repair of High Imperforate Anus with Fistula

    Showing 1–10 of 20

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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