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Official Description

Sphincteroplasty, anal, for incontinence, adult; muscle transplant

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Sphincteroplasty, specifically CPT® Code 46760, refers to a surgical procedure aimed at repairing the anal sphincter in adults who experience incontinence. This condition may arise due to various factors, including traumatic injuries to the anus or perineum, complications following hemorrhoidectomy, or surgical interventions for rectal prolapse or tumors. The procedure involves the use of a muscle transplant, typically the gracilis muscle, which is harvested from the thigh. The surgical approach includes making incisions to access the gracilis muscle, which is then carefully dissected and prepared for transplantation. The muscle is subsequently positioned to encircle the anus, providing support and restoring function. This procedure is critical for patients suffering from anal incontinence, as it aims to enhance their quality of life by improving bowel control and reducing involuntary leakage.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure of anal sphincteroplasty using muscle transplant (CPT® Code 46760) is indicated for adults experiencing incontinence due to various underlying conditions. The following are specific indications for this surgical intervention:

  • Traumatic Injury - Incontinence resulting from trauma to the anus or perineum.
  • Hemorrhoidectomy Complications - Incontinence that may occur as a complication following the surgical removal of hemorrhoids.
  • Low Transanal Rectal Resection - Incontinence following a low transanal rectal resection performed for tumor or disease.
  • Surgical Repair of Rectal Prolapse - Incontinence that develops after surgical procedures aimed at correcting rectal prolapse.

2. Procedure

The surgical procedure for anal sphincteroplasty using muscle transplant involves several detailed steps to ensure proper repair and restoration of function. The following outlines the procedural steps:

  • Step 1: Muscle Harvesting - The gracilis muscle is accessed through one long or multiple short incisions made in the mid-thigh area. The muscle is carefully dissected free from surrounding tissues, and small arteries supplying the muscle are ligated to prevent excessive bleeding.
  • Step 2: Muscle Preparation - The distal tendon insertion of the gracilis muscle is exposed and transected. The muscle is then dissected proximally to the main neuromuscular bundle, ensuring that it remains intact for transplantation.
  • Step 3: Perineal Incisions - Two incisions are made in the perineum, lateral to the anus. Tunnels are created anteriorly and posteriorly around the anus, taking care to avoid any injury to the rectum and vagina during this process.
  • Step 4: Tunnel Creation - A tunnel is fashioned between the thigh and perineal incisions, allowing for the gracilis muscle to be brought up to encircle the anus effectively.
  • Step 5: Muscle Attachment - The distal tendon of the gracilis muscle is sutured to the periosteum of the pubic bone on the contralateral side. Alternatively, it may be attached to the periosteum of the ischial tuberosity or to subcutaneous tissue, depending on the surgical approach and anatomical considerations.
  • Step 6: Closure - Finally, the incisions made during the procedure are closed, ensuring that the surgical site is properly secured and that healing can commence.

3. Post-Procedure

After the anal sphincteroplasty procedure, patients can expect a recovery period that may involve monitoring for complications such as infection or bleeding. Post-operative care typically includes pain management and instructions for activity restrictions to promote healing. Patients may also be advised on dietary modifications to ease bowel movements and reduce strain during recovery. Follow-up appointments are essential to assess the surgical site, evaluate the success of the procedure, and address any concerns that may arise during the healing process.

Short Descr REPAIR OF ANAL SPHINCTER
Medium Descr SPHINCTEROPLASTY ANAL MUSCLE TRANSPLANT
Long Descr Sphincteroplasty, anal, for incontinence, adult; muscle transplant
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - other
MUE 1
CCS Clinical Classification 96 - Other OR lower GI therapeutic procedures
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
GC This service has been performed in part by a resident under the direction of a teaching physician
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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