CPT 46606 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 • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| CMS | $263.62 Physician Fee Schedule |
National average reimbursement for CPT 46606 by major payers:
$290.28
$306.86
$369.93
$423.73
| 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 46606 | ||||||
United | 46606 | $1233.00 | 1902959190 - RIVA ROAD SURGICAL CENTER, LLC | 870774597 - (MD) RIVA ROAD SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46606 | $1276.00 | 1720085277 - ROSWELL SURGERY CENTER LLC, ROSWELL SURGERY CENTER | 582577112 - (GA) ROSWELL SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46606 | $800.00 | 1851475461 - TEXOMA VALLEY SURGERY CENTER LP | 752917581 - (TX) TEXOMA VALLEY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46606 | $2172.00 | 1578530226 - PHYSICIANS SURGICAL CENTER OF FT. WORTH LLP, BAYLOR SCOTT & WHITE SURGICARE FORT WORTH | 208303422 - (TX) PHYSICIANS SURGICAL CENTER OF FT WORTH LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46606 | $821.00 | 1750481453 - LONGVIEW SURGICAL CENTER LLC, PACIFIC SURGICAL CENTER | 161678767 - (WA) LONGVIEW SURGICAL CENTER, LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46606 | $616.00 | 1497751747 - MID-ATLANTIC ENDOSCOPY CENTER, LLC, MID-ATLANTIC GASTROINTESTINAL CENTER II | 233096335 - (DE) MIDATLANTIC ENDOSCOPY CENTER LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46606 | $193.63 | 1386074474 - GEORGE DEREFAKA | 350593390 - DEACONESS HOSPITAL INC | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | 46606 | $193.63 | 1518561687 - KARI CLARIDGE | 350593390 - DEACONESS HOSPITAL INC | IN | Medical Physician Assistant (363AM0700X) |
United | 46606 | $1167.00 | 1346969789 - ADVENTHEALTH SURGERY CENTER INNOVATION TOWER, LLC | 882744377 - (FL) ADVENTHEALTH SURGERY CENTER INNOVATION TOWER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46606 | $646.00 | 1336143148 - MARIN OPHTHALMIC SURGERY CENTER | 680297790 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46606 | $1188.00 | 1104233014 - TAMPA MINIMALLY INVASIVE SPINE SURGERY CENTER, LLC | 471211888 - (FL) TAMPA MINIMALLY INVASIVE SPINE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46606 | $1809.00 | 1568427151 - PLANO AMBULATORY SURGERY ASSOCIATES, LP | 621560420 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46606 | $1886.00 | 1295776920 - ROSE AMBULATORY SURGERY CENTER LP | 200415436 - (CO) ROSE AMBULATORY SURGERY CENTER LP | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46606 | $575.00 | 1497367262 - SNKS ENTERPRISES LLC, SOL VALLEY SURGERY CENTER | 364932587 - (AZ) SNKS ENTERPRISES LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46606 | $2480.00 | 1033586136 - PHYSICIANS WEST HOUSTON SURGICAL CENTER, LLC, MEMORIAL HERMANN SURGERY CENTER PARK TEN | 371789833 | 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 46606 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46606 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 46606 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) |
| 46604-CPT | Moderate | Anoscopy W Dilation Direct |
| 46606-CPT | Moderate | Anoscopy; For Biopsy |
| 46607-CPT | Moderate | Anoscopy, Diagnostic With High-Resolution Magnification (Hra) (Eg, Colposcope, Operating Microscope) And Chemical Agent Enhancement, With Biopsy, Single Or Multiple |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46606. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46606 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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