CPT 46080 Surgery - Digestive

How Much Does Sphnctrotmy Anal Div Sphnctr Cost?

Also known as: Sphnctrotmy anal div sphnctr (CPT 46080)

Surgical treatment of an anal fissure (lateral internal sphincterotomy).

Sphnctrotmy Anal Div Sphnctr (CPT 46080) costs $150 at Medicare rates. Hospital outpatient rate: $2.

Cost Comparison by Payer

How much Sphnctrotmy anal div sphnctr costs across different settings and payers

Medicare
Facility rate
$150
Hospital Outpatient
OPPS rate
$2
Surgery Center
ASC rate
$1
Medicare (Facility)
$150
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$316
Non-facility setting
Hospital Outpatient
$2
OPPS rate
Surgery Center (ASC)
$1
Ambulatory surgery center

Patient Guide: Sphnctrotmy Anal Div Sphnctr

What you need to know before your appointment

What to Expect

Under anesthesia, the surgeon makes a small cut in the internal sphincter muscle to reduce spasm and allow the fissure to heal. This is an outpatient procedure.

How Long Does It Take?

15-30 minutes

Common Reasons Doctors Order This

Chronic anal fissure not healing with conservative treatment, painful bowel movements, anal fissure lasting more than 6-8 weeks

How to Prepare

Fast before surgery. Take stool softeners before and after. Sitz baths help with healing. Most patients feel significant pain relief quickly.

Procedures Commonly Done Together

These procedures are frequently performed alongside Sphnctrotmy anal div sphnctr

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How to Reduce Your Cost for Sphnctrotmy anal div sphnctr

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($316) differs from the facility rate ($150). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $1, compared to $2 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

2.46
Work RVU
1.54
Practice Expense RVU
0.49
Malpractice RVU
9.45
Total RVU

Payment = Total RVU (9.45) x CF ($33.40) = $316

Frequently Asked Questions

How much does Sphnctrotmy anal div sphnctr cost?

The Medicare facility rate for Sphnctrotmy anal div sphnctr is $150. In a hospital outpatient setting, the rate is $2. At an ambulatory surgery center, the rate is $1. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Sphnctrotmy anal div sphnctr cost without insurance?

Without insurance, the cost of Sphnctrotmy anal div sphnctr can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Sphnctrotmy anal div sphnctr?

Most commercial health insurance plans and Medicare cover Sphnctrotmy anal div sphnctr when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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