CPT code 46740 represents surgical repair of a high imperforate anus with an associated rectourethral or rectovaginal fistula, performed via a perineal or sacroperineal approach. This procedure addresses a congenital anorectal malformation that typically requires specialized pediatric colorectal surgical expertise and inpatient operative care. Nationally, proper coding for this complex reconstructive surgery affects case classification, hospital resource use, and surgical quality measurement for congenital anorectal anomalies.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and the common billing considerations tied to this code. The publication outlines benchmarks related to utilization and payment patterns, summarizes relevant policy or coverage considerations affecting access to specialized pediatric surgical care, and highlights coding nuances that commonly arise with high imperforate anus repairs. Where input data are incomplete, the text notes when specific payer policy details or associated diagnosis lists are not available.

This summary is intended for clinicians, coding professionals, and policy analysts seeking a focused overview of CPT code 46740, its clinical significance, and the administrative context around billing and coverage for complex pediatric anorectal reconstruction.