CPT 46505
Global 010 ActiveChemodenervation anal musc
CPT 46505 Billing & Documentation Guide
CPT code 46505 (Chemodenervation anal musc) is classified under Surgery (Digestive) with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.1, a non-facility practice expense RVU of 6.61, and a malpractice RVU of 0.55, a total non-facility RVU of 10.26 and facility RVU of 7.38. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $351.8, though rates vary from $302.65 to $443.14 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 46505, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 46505 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
10-day global period (minor procedure: pre-op day + procedure + 10 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 46505 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 46505
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.1 | 3.1 |
| Practice Expense RVU | 6.61 | 3.73 |
| Malpractice RVU | 0.55 | 0.55 |
| Total RVU | 10.26 | 7.38 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 46505
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $378.46 | $264.64 | $357.12 - $443.14 | 29 |
| Florida | $360.82 | $264.31 | $342.22 - $379.83 | 3 |
| Georgia | $336.31 | $244.54 | $322.38 - $350.23 | 2 |
| Illinois | $352.34 | $259.39 | $333.83 - $368.31 | 4 |
| Michigan | $336.72 | $246.39 | $325.86 - $347.57 | 2 |
| North Carolina | $321.27 | $231.52 | $321.27 - $321.27 | 1 |
| New York | $379.73 | $272.41 | $326.2 - $406.79 | 5 |
| Ohio | $323.63 | $235.81 | $323.63 - $323.63 | 1 |
| Pennsylvania | $340.37 | $246.14 | $323.58 - $357.15 | 2 |
| Texas | $338.53 | $243.83 | $321.52 - $353.61 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 46505
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 46505 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00902 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0226T | Column 1 (primary), can be billed with modifier | No | CPT Separate procedure definition |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0288T | Column 1 (primary), can be billed with modifier | No | CPT Separate procedure definition |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 46505
What does CPT code 46505 mean? +
CPT code 46505 represents: Chemodenervation anal musc. It's in the Surgery (Digestive) category with a global period of 010.
What is the Medicare reimbursement for CPT 46505? +
The 2026 Medicare national average non-facility payment for CPT 46505 is $351.8. Rates range from $302.65 to $443.14 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 46505? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 46505? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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