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See a sample rate comparisonCPT 46288 Fee Schedule
Last Verified: October 2026
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.
Surgery To Close Anal Fistula, Surgery To Close Off An Anal Fistula. This Is A Small Abnormal Tunnel That Starts In The Anal Canal Or Passageway And Ends At The Surface Of Skin Or Elsewhere In The Body.
| Key Fact | Detail |
|---|---|
| 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 58 - Staged or related procedure during postoperative period 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 46288 |
| Medicaid Fee Schedule | View Medicaid rates for 46288 |
National average reimbursement for CPT 46288 by major payers:
$692.84
$717.61
$772.64
$893.45
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CPT 46288
5 of 25 sample ratesHigher to lower in this preview
Calloway Creek Surgery Center Lp
$5,124.00Published rateWillamette Surgery Center LLC
Willamette Surgery Center, P.C.
$2,380.00Published rateOutpatient Surgery Center Of Hilton Head
$1,900.00Published rateFort Washington Surgery Center, LLC, The Surgery Center At Fort Washington
Foundation Surgery Affiliates Of Fort Washington, LLC
$1,176.00Published rateAnna Boone
Deaconess Hospital Inc
$443.70Published rate
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See a sample payer proposalCPT 46288 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46288 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 46288 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 |
|---|---|---|
| 46275-CPT | Moderate | Surgery To Close Anal Fistula, Surgery To Close Off An Anal Fistula. This Is A Small Abnormal Tunnel That Starts In The Anal Canal Or Passageway And Ends At The Surface Of Skin Or Elsewhere In The Body. |
| 46285-CPT | Moderate | Surgery To Close Anal Fistula, Surgery To Close Off An Anal Fistula. This Is A Small Abnormal Tunnel That Starts In The Anal Canal Or Passageway And Ends At The Surface Of Skin Or Elsewhere In The Body. |
| 46288-CPT | Moderate | Surgery To Close Anal Fistula, Surgery To Close Off An Anal Fistula. This Is A Small Abnormal Tunnel That Starts In The Anal Canal Or Passageway And Ends At The Surface Of Skin Or Elsewhere In The Body. |
| 46505-CPT | Moderate | Relax Muscle Around Anus, Procedure Using Chemical Agents To Relax The Muscles Around The Anal Opening To Heal Surrounding Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46288. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46288 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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