Data Platform
Sign InTry for Free

CPT 46020 Fee Schedule

Last Verified: November 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Placement Of Seton
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

22 - On Campus Outpatient Hospital

24 - Ambulatory Surgical Center

Common Modifiers

None

51 - Multiple procedures

59 - Distinct Procedural Service

Complexity LevelModerate
CMS$114.18 Physician Fee Schedule

National average reimbursement for CPT 46020 by major payers:

bcbs

$221.72

uhc

$345.69

aetna

$295.23

cigna

$301.06

Preview provider-level rates for...
For billing codeCPT 46020
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 46020

United
46020$1526.001407539539 - RSC SURGERY CENTER, LLC352345966CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$3262.001750517561 - CANON CITY CO MULTI SPECIALTY ASC LLC, ARKANSAS VALLEY SURGERY CENTER264730485 - (CO) CANON CITY CO MULTI SPECIALTY ASC LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$982.001245215706 - SOUTHSIDE FOOT CLINIC OF SHREVEPORT INC A PROFESSIONAL CORPORATION, THE FOOT SURGERY CENTER OF SHREVEPORT721198169 - (LA) SOUTHSIDE FOOT CLINIC OF SHREVEPORT INC A PROFESSIONAL CORPORATIONLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$640.001306963020 - BATTLE CREEK ENDOSCOPY & SURGERY LLC201914507 - (MI) BATTLE CREEK ENDOSCOPY & SURGERY CENTER PLLCMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$1854.001578142352 - CHELMSFORD SURGERY CENTER LLC854172372 - (MA) CHELMSFORD SURGERY CENTER LLCMAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$2206.001144331760 - RESURGENS SURGERY CENTER LLC582397841 - (GA) RESURGENS SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$519.001073030532 - AKDHC SURGERY CENTER, LLC753052504AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$1200.001578876124 - GOLD COAST SURGICENTER, LLC271495683 - (IL) GOLD COAST SURGICENTER, LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$1000.001962466847 - GULF COAST ENDOSCOPY CENTER OF VENICE LLC650954372 - (FL) GULF COAST ENDOSCOPY CENTER OFFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$3871.001104947357 - TARRANT COUNTY SURGERY CENTER LP710985084 - (TX) TARRANT COUNTY SURGERY CENTER LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$1561.001437623626 - PRIME SURGICAL SUITES, LLC, SCSV, LLC463556921 - (NC) PRIME SURGICAL SUITES LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$1180.001518450790 - VIRGINIA ENT SURGERY CENTER INC541052755 - (VA) VIRGINIA EAR, NOSE & THROAT ASSOCIATES, P.C.VAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$1033.001306924170 - DELMAR SURGICAL CENTER LLC621717312 - (MD) DELMAR SURGICAL CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$1701.001376230722 - UCHEALTH AMBULATORY SURGERY CENTERS, UCHEALTH EASTVIEW SURGERY CENTER383984888 - (CO) UCHEALTH AMBULATORY SURGERY CENTERSCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
46020$1700.001194437624 - WATAUGA SURGICAL PARTNERS PLLC862624496 - (TN) WATAUGA SURGICAL PARTNERS PLLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

Want to see your competitors' rates?

Start your trial today to unlock complete access to provider rates and fee schedules in your area.

Here's what you can do with PayerPrice

Renegotiate your managed care contracts

Benchmark your current rates against market averages to identify opportunities for rate optimization.

Prospect for new business using fee schedules

Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.

Integrate real-time payer data into your workflows

Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.

PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.

CPT 46020 vs. Other Surgical Procedures on the Digestive System Codes

The CPT 46020 code is part of the Surgery services used for Surgical Procedures on the Digestive 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 46020 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.

CodeComplexityDescription
45999-CPTModerateUnlisted Procedure Rectum
46020-CPTModeratePlacement Of Seton
46030-CPTModerateRemove Seton/Other Marker Anal
46040-CPTModerateI&D Abscess Ischiorectal/Perirectal

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 46020 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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like CPT 46020) and we'll show you how you compare in 15 minutes or less.