CPT 46601 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • AG - Primary physician • UA |
| Complexity Level | Moderate |
| CMS | $144.27 Physician Fee Schedule |
National average reimbursement for CPT 46601 by major payers:
$237.94
$191.12
$264.87
$273.65
| 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 46601 | ||||||
United | 46601 | $283.00 | 1275513806 - PINNACLE CATARACT AND LASER INSTITUTE LLC | 743117000 - (WI) PINNACLE CATARACT AND LASER INSTITUTE LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $525.00 | 1073149365 - MEDFORD SURGERY CENTER LLC | 384079196 - (MA) MEDFORD SURGERY CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $207.00 | 1659772648 - SURGICAL SPECIALTY CENTER OF MID ATLANTIC, LLC | 465727021 - (MD) SURGICAL SPECIALTY CENTER OF MID-ATLANTIC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $88.00 | 1629153770 - COTTMAN AMBULATORY SURGERY CENTER, WILLS SURGERY CENTER OF THE NORTHEAST | 232786584 - (PA) COTTMAN AMBULATORY SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $202.00 | 1457552846 - CHESTERFIELD SPINE CENTER, LLC, ST. LOUIS SPINE AND ORTHOPEDIC SURGERY CENTER | 205044859 - (MO) CHESTERFIELD SPINE CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $932.00 | 1063442077 - INOVA LOUDOUN AMBULATORY SURGERY | 203523190 - (VA) INOVA LOUDOUN AMBULATORY SURGERY | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $914.00 | 1760035158 - LEIGH ORTHOPEDIC SURGERY CENTER, LLC | 832402528 - (VA) LEIGH ORTHOPEDIC SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $113.00 | 1578643607 - PAIN CENTER LLC | 331048492 - (AR) THE PAIN CENTER OF JONESBORO, LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $107.00 | 1780958207 - LANCASTER SURGERY CENTER, INC. | 320361416 - (OH) LANCASTER SURGERY CENTER INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $150.00 | 1124571104 - UROLOGY SURGERY CENTER JOHNS CREEK LLC | 811521583 - (GA) UROLOGY SURGERY CENTER JOHNS CREEK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $200.00 | 1417409285 - BEAUMONT ASC, LP, BEAUMONT HEART & VASCULAR SURGERY CENTER | 814050976 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $2500.00 | 1528069218 - NORTHSHORE REGIONAL MEDICAL CENTER DBA THE SURGERY SUITE, THE SURGERY SUITE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $633.00 | 1639433956 - LOWCOUNTRY AMBULATORY CENTER, LLC | 274109893 - (SC) LOWCOUNTRY AMBULATORY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $108.00 | 1669720439 - OCALA SURGICAL CENTER, OCALA SURGICAL CENTER, LLC | 842579958 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46601 | $887.00 | 1356878052 - PAVILION SURGERY CENTER LLC | 814376492 - (CA) PAVILION SURGERY CENTER LLC | CA | 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 46601 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46601 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 46601 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 |
|---|---|---|
| 46600-CPT | Low | Anoscopy; Diagnostic Including Collection Of Specimen(S) By Brushing Or Washing When Performed(Separate Procedure) (Desc Revised 01/01/15) |
| 46601-CPT | Moderate | Anoscopy; Diagnostic With High-Resolution Magnification (Hra) (Eg Colposcope Operating Microscope) And Chemical Agent Enhancement Including Collection Of Specimen(S) By Brushing Orwashing When Performed |
| 46607-CPT | Moderate | Anoscopy, Diagnostic With High-Resolution Magnification (Hra) (Eg, Colposcope, Operating Microscope) And Chemical Agent Enhancement, With Biopsy, Single Or Multiple |
| 46611-CPT | Moderate | Anoscopy; W Removal Of Single Tumor/Polyp/Lesion By Snare Technique |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46601. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46601 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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