CPT 15946 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Integumentary System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 79 - Unrelated procedure - postop period • 58 - Staged or related procedure during postoperative period |
| Complexity Level | High |
National average reimbursement for CPT 15946 by major payers:

$2,127.25

$2,098.50

$2,054.34

$2,629.80
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 15946 | ||||||
United | 15946 | $558.00 | 1285673186 - BERKSHIRE COSMETIC & RECONSTRUCTIVE SURGERY CENTER INC. | 43421240 - (MA) BERKSHIRE COSMETIC RECONSTRUCTIVE SURGERY CENTER INC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $995.00 | 1144482753 - CLARKSVILLE EYE SURGERY CENTER | 261815638 - (TN) CLARKSVILLE EYE SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $2305.00 | 1407046436 - NORTHWOODS SURGERY CENTER, LLC | 260434501 - (WI) NORTHWOODS SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $2307.00 | 1538126362 - WINTER HAVEN AMBULATORY SURGICAL CENTER LLC | 593659906 - (FL) WINTER HAVEN AMBULATORY SURGICAL CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $1090.00 | 1316406523 - JOHNS HOPKINS SURGERY CENTERS SERIES, GREEN SPRING STATION SURGERY CENTER | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $959.00 | 1598804486 - SHREVEPORT SURGERY CENTER PTRSHP | 721126552 - (LA) SHREVEPORT SURGERY CENTER OF CADDO PARISH, INC. | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $1126.00 | 1386618783 - LEWES DE ENDOSCOPY ASC LLC, SEASIDE ENDOSCOPY PAVILION | 562299727 - (DE) LEWES DE ENDOSCOPY ASC LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $1429.00 | 1568489086 - MED ATLANTIC INC, MED ATLANTIC INC DBA UROSURGICAL CTR OF RICHMOND | 541759643 | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $2050.00 | 1811076623 - SPARTANBURG SURGERY CENTER, LLC | 570953005 - (SC) SPARTANBURG SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $965.00 | 1164404638 - CAMPUS EYE GROUP ASC INC, SURGICENTER ANESTHESIA ASSOCIATES | 223047283 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $1710.00 | 1437505948 - WATER LEAF SURGERY CENTER, LTD | 811356283 - (TX) WATER LEAF SURGERY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $1300.00 | 1437691177 - FRESENIUS VASCULAR CARE CINCINNATI ASC LLC, AZURA SURGERY CENTER CINCINNATI | 814225843 - (OH) FRESENIUS VASCULAR CARE CINCINNATI ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $1114.00 | 1154318376 - LAHAYE CENTER FOR ADVANCED EYE CARE OF LAFAYETTE, INC. | 721227426 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $1131.00 | 1063905818 - INNOVATIVE EYE SURGERY CENTER, PLLC | 822843902 - (KY) INNOVATIVE EYE SURGERY CENTER PLLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15946 | $774.00 | 1386823854 - THE GLENDALE AZ ENDOSCOPY ASC LLC, THUNDERBIRD ENDOSCOPY CENTER | 260506545 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 15946 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15946 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 15946 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15946. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15946 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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