CPT 46250 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Digestive System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| CMS | $469.02 Physician Fee Schedule |
National average reimbursement for CPT 46250 by major payers:
$567.89
$600.68
$655.92
$761.60
| 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 46250 | ||||||
United | 46250 | $3608.00 | 1558627406 - CARMEL SPECIALTY SURGERY CENTER LLC | 454729527 - (IN) CARMEL SPECIALTY SURGERY CENTER, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46250 | $520.00 | 1558857177 - MIDLAND AMBULATORY SURGERY CENTER, LLC, ANAND CHOLIA MBR | 825037025 - (TX) MIDLAND AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46250 | $1155.00 | 1578593281 - SOUTH ORANGE COUNTY OUTPATIENT SURGICAL CENTER INC, SOUTH ORANGE COUNTY OUTPATIENT SURGERY CENTER | 330269133 - (CA) SOUTH ORANGE COUNTY OUTPATIENT SURGICAL CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46250 | $816.91 | 1902850068 - CHONG NICHOLLS | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
United | 46250 | $1000.00 | 1407932619 - PACIFIC EYE INSTITUTE A MEDICAL GROUP INC, PACIFIC EYE INSTITUTE AMBULATORY SURGERY CTR | 330303507 - (CA) PACIFIC EYE INSTITUTE MEDICAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46250 | $2307.00 | 1841395894 - FRANKLIN ENDOSCOPY CENTER, LLC, FRANKLIN ENDOSCOPY CENTER | 383730672 - (TN) FRANKLIN ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46250 | $375.33 | 1538337019 - RORI SPRAY | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 46250 | $1062.00 | 1275536393 - MEDICAL CENTER SURGERY ASSOCIATES, LP | 621449272 - (FL) MEDICAL CENTER SURGERY ASSOCIATES LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46250 | $520.00 | 1649931072 - MEDICAL CITY SPECIALTY SURGICENTER OF DALLAS, LLC, MEDICAL CITY ORTHOPEDIC & SPINE SURGERY CENTER DALLAS | 842824507 - (TX) MEDICAL CITY SPECIALTY SURGICENTER OF DALLAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46250 | $1155.00 | 1609400290 - ORTHOPAEDIC ASSOCIATES OF CENTRAL TEXAS SURGERY CENTER, LLC | 844818321 - (TX) ORTHOPAEDIC ASSOCIATES OF CENTRAL TEXAS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46250 | $580.00 | 1780658062 - GLEN ENDOSCOPY CENTER, LLC | 364486546 - (IL) THE GLEN ENDOSCOPY CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46250 | $2814.00 | 1881692036 - SAINT BARNABAS OUTPATIENT CENTERS, AMBULATORY SURGERY CENTER | 222458479 - (NJ) SAINT BARNABAS OUTPATIENT CENTERS | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46250 | $550.00 | 1811052749 - GDC ENDOSCOPY CENTER LLC | 651240653 - (GA) GDC ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46250 | $375.33 | 1962641431 - LARESSA BAZZELL | 350593390 - DEACONESS HOSPITAL INC | KY | Certified Registered Nurse Anesthetist (367500000X) |
United | 46250 | $520.00 | 1356798854 - MID CITIES ASC, LP | 811663790 | TX | 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 46250 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46250 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 46250 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.
| Code | Complexity | Description |
|---|---|---|
| 46221-CPT | Moderate | Hemorrhoidectomy, Internal, By Rubber Band Ligation(S) |
| 46230-CPT | Moderate | Removal Of Multiple External Benign Growths (Papillas Or Tags) Of Anus |
| 46250-CPT | Moderate | Hemorrhoidectomy,External,2 Or More Columns Or Groups |
| 46255-CPT | Moderate | Hemorrhoidectomy, Internal And External, Single Column/Group; |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46250. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46250 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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