CPT 46505 Chemodenervation of internal anal sphincter
RVU Snapshot
- Work RVU: 3.10
- Non-facility PE RVU: 6.61
- Facility PE RVU: 3.73
- MP RVU: 0.55
- Non-facility total RVU: 10.26
- Facility total RVU: 7.38
- Estimated Medicare payment: $342.69
- Estimated facility Medicare payment: $246.50
- Global period: 010
- Status indicator: A
- Assistant surgeon indicator: 1
- Co-surgeon indicator: 0
- Team surgeon indicator: 0
- Bilateral indicator: 0
- Multiple procedure indicator: 2
Clinical Search Terms
Botox anal fissure, anal fissure Botox, internal anal sphincter Botox, internal anal sphincter injection, chemodenervation, sphincter injection, chronic anal fissure Botox.
Diagnosis Pointer Support
Common supported ICD-10 pointers include K60.1 chronic anal fissure, K60.2 anal fissure unspecified, K60.0 acute anal fissure, K59.4 anal spasm, and K62.89 other specified diseases of anus and rectum when documentation supports sphincter chemodenervation.
Coding Note
Case Builder uses the same total-RVU Medicare payment estimate and applies modifier, MPPR, diagnosis-pointer, and NCCI checks at the case level.
Sources: RVU values and CMS indicators from CMS PFS RVU26C July 2026 non-QPP. NCCI relationships from CMS NCCI Practitioner PTP 2026-Q3. Educational coding support only; confirm final billing against AMA CPT, CMS MPFS, NCCI, and payer policy.