CPT 46607 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 • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| CMS | $198.93 Physician Fee Schedule |
National average reimbursement for CPT 46607 by major payers:
$337.03
$267.71
$414.38
$374.99
| 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 46607 | ||||||
United | 46607 | $687.00 | 1174601223 - BEL CLAIR AMBULATORY SURGICAL TREATMENT CENTER, LTD., BEL CLAIR SURGICAL CENTER | 371301073 - (IL) BEL CLAIR AMBULATORY SURGICAL TREATMENT CENTER LTD | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46607 | $344.67 | 1841228822 - DEACONESS HOSPITAL, INC, <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 46607 | $936.00 | 1336553833 - CENTER FOR CARDIOVASCULAR RESEARCH AND EDUCATION LLC | 465327973 - (AZ) CENTER FOR CARDIOVASCULAR RESEARCH AND EDUCATION LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46607 | $1735.00 | 1093352908 - BAPTIST HEALTHCARE SYSTEM, INC., BAPTIST HEALTH SURGERY CENTER EASTPOINT | 610444707 - BAPTIST HEALTHCARE SYSTEM INC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46607 | $2657.00 | 1497244149 - HOSPITAL FOR SPECIAL SURGERY WEST SIDE AMBULATORY SURGERY CENTER, LLC, HSS WEST SIDE ASC, LLC | 814351390 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46607 | $1528.00 | 1629386784 - ODESSA ENDOSCOPY CENTER LLC | 273305505 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46607 | $589.00 | 1225252257 - EYE ASSOCIATES SURGERY CENTER INC, CASCADIA SURGICAL | 274532347 - (WA) EYE ASSOCIATES SURGERY CENTER INC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46607 | $580.00 | 1497740617 - LAKE COUNTY PAIN & DIAGNOSTIC | 651216636 - (OH) LAKE COUNTY PAIN DIAGNOSTIC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46607 | $344.67 | 1114946852 - CHRISTOPHER STEWART | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 46607 | $2716.00 | 1174588099 - IU HEALTH ARNETT HOSPITAL, INC, ARNETT SURGERY CENTER, LLC | 263162145 - (IN) INDIANA UNIVERSITY HEALTH ARNETT INC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46607 | $614.00 | 1275184293 - JOHNS HOPKINS SURGERY CENTERS SERIES, BEL AIR SURGERY CENTER | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46607 | $1390.00 | 1306833009 - SOUTH BROWARD ENDOSCOPY L L C | 113685842 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46607 | $622.00 | 1396983847 - EYE SURGERY CENTER LLC, THE EYE SURGERY CENTER | 263915695 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46607 | $750.00 | 1750434759 - TOWER OAKS SURGERY CENTER, LLC | 204877029 - (MD) TOWER OAKS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46607 | $600.00 | 1073581880 - AMBULATORY SURGERY CENTER LLC, THE CENTER FOR SAME DAY SURGERY | 481114690 - (KS) AMBULATORY SURGERY CENTER, LLC | KS | 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 46607 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46607 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 46607 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 |
|---|---|---|
| 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 |
| 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 46607. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46607 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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